Linda, a California lawyer who was fired from her job in January, is like millions of others in a pandemic living without health insurance.
But he found that the government would fully subsidize COBRA health insurance premiums from April to September, thanks to a provision in the latest stimulus package. He immediately contacted his insurer to sign up. Linda (asked not to use her full name) was eager to go to the doctor after contracting a painful urinary tract infection this month, which she feared could spread to her kidneys.
The rules for the $ 1.9 trillion relief bill passed in March seemed simple enough: the government would pay people’s COBRA premiums for six months starting April 1st. or more employees stay in the occupational insurance plan if they can pay both the part of the premium and the fee previously paid by their employer.
Of course, many people who have just stopped can’t afford it, but this provision of the stimulus package aims to change that by reducing people’s monthly insurance premiums for six months.
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But when Linda emailed her former insurer in April to ask if she could go to the doctor to treat her infection, she was surprised to be told the government subsidy is not yet available.
“[F]According to the email seen by CNBC, “the IRS or the DOL have not provided or terminated the processes or processes,” until we are notified otherwise, we must operate as “normal.”
“It’s frustrating to say the least,” said Linda, who worries she’ll have to go to the emergency room for her infection and recover the debt. He has also had to stop taking medication for anxiety and depression due to its cost.
Health care advocates are concerned that many other people may run into similar problems trying to access the temporary COBRA grant, which the U.S. Department of Labor has said began on April 1st.
The implementation of the new system will require coordination between various government agencies, companies and insurers. Meanwhile, employers don’t even have to warn those who might be eligible until the end of May.
“Is it available for such a short period of time and you don’t even know about it until May 31st?” said Sabrina Corlette, co-director of the McCourt School of Public Policy at Georgetown University’s Health Insurance Reform Center. “A lot of people can miss the opportunity.”
The Department of Labor did not respond to any requests for comment.
As the new grant launches, that’s what we know.
What if my insurer says it still can’t offer the subsidy?
The good news is that even if you can’t sign up for a few weeks or months due to operational delays, if you qualify for the COBRA grant, any eligible claims accrued after April 1 (and before by the end of September) should be covered, experts say.
But expect to have to put in some work to fix it.
Keep all of your medical records during this period, said Caitlin Donovan, a spokeswoman for the Patient Advocate Foundation, a nonprofit organization that helps patients access and pay for health care.
“Keep a folder with all the paperwork you have, the checks you write and order receipts,” Donovan said.
Doing so will make it easier for you to submit any claims or invoices to your insurer once the benefit begins, or you will be reimbursed for any expenses you have established that meet the requirements for coverage.
If you’re worried about upfront costs, try explaining to your doctors that you’re waiting for your COBRA coverage to begin and ask if they can wait to bill your insurer, according to experts.
Who is entitled to the grant?
He will be eligible if he inadvertently left a job that offered health insurance and did not meet the requirements for another business plan or Medicare, Donovan said.
“He would even qualify if he rejected COBRA sooner,” Donovan said.
Any family member in your plan would also be fully covered. If you still have your job, but your hours have been reduced to the point where you have lost access to your company’s health insurance plan, you can also qualify for the six-month benefit.
You should receive written notice of your eligibility, probably from your employer or health insurance company. If you have not heard anything, contact your former insurer.
How does my grant change costs?
How long will the grant last?
The grant will run until September 30, 2021.
Normally, you can’t be in COBRA for more than 18 months in total, so some people may be cut off before that date, depending on when they started their coverage.
What if I have already declined COBRA coverage?
Do not you worry. It is not too late to take advantage of this relief.
Dismissed workers must normally register with COBRA within 60 days of the completion of their work. But even if, for example, you declined coverage in August 2020 because premiums were too high, you can now go back and sign up, according to the Georgetown University Health Policy Institute.
Please note, however, that once you have received notice of your eligibility for COBRA, you must register within 60 days.
Will I have to pay for months that I was not insured through COBRA?
Normally, if you don’t sign up for COBRA right away and decide to do so later, you’ll have to pay your premiums again because you’re not allowed to have a coverage gap.
The relief bill temporarily changes this policy.
According to Georgetown experts, you should not pay premiums until the date you were originally entitled to enroll in COBRA.
However, you will only be covered for claims from April 1st.
When does coverage through COBRA make sense?
The biggest drawback of COBRA is usually the cost to laid off workers, which can be as much as thousands of dollars a month. The relief bill removes this hurdle, at least until September.
One of the main benefits of COBRA is that you can keep your current doctors and health care providers. If you’ve already met your deductible for the year, maintaining job insurance could be even more affordable compared to other plans, according to experts.
Other insurance options for the unemployed include Medicaid and buying a plan in the Accordable Care Act market.
Medicaid can make sense if you expect your financial problems to last for a long time, and they won’t leave you monthly premiums.
Meanwhile, some unemployed Americans may opt for a free market plan on the ACA exchange, or Obamacare, following the changes made to the latest stimulus package. For example, if you have taken out unemployment insurance during the year, you can opt for a free silver plan.
Not only will you have to pay a premium, but your out-of-pocket expenses can also be minimal.
“As a result, a marketing plan may be better for you,” said Edwin Park, a research professor in the McCourt School of Public Policy at Georgetown University.
If I sign up for COBRA, what will be my options at the end of September?
Unfortunately, there is still no good answer.
Currently, the government has not said it will offer people who take advantage of the COBRA grant a special enrollment period in late September, except in strict circumstances. (Special enrollment periods allow people to take out health insurance plans in the market outside the normal window).
Elected officials have written this month to U.S. Secretary of Health and Human Services Xavier Becerra to ask him to create a special enrollment period when the grant expires.
If none is set, they warn, “this will leave many consumers without a realistic option to find affordable coverage until the open enrollment period for plans starting in 2022.”
Having trouble accessing the new COBRA grant? Email me at [email protected]