The COVID 19 Crisis & Health Insurance
The crisis is putting financial pressure on businesses and families. During this time we understand it is more important than ever before to access, afford and use your health insurance. With this in mind we have put together some helpful information.
What is fully insured versus self-insured?
Fully insured plans are plans that are backed by the carrier, the carrier, like BCBS or UHC, pays the insurance claims. Self-Insured plans are typically held by large employers or associations and those organizations decide what is covered and pay for the claims. All of the clients at The Insurance People are on fully insured policies.
More on what to expect right now on a fully insured policy
- Your insurance will cover, at no cost, testing to confirm if you have COVID 19. You will not pay anything to get tested.
- If you are diagnosed with COVID 19 and need services your policy will function like normal with its copays, deductible/coinsurance and max out of pocket (OPX).
- The Insurance People will help any client, and their staff with claim processing that transpires from COVID 19 diagnosis. This means that once you get your bills from the hospital signal us and we will coordinate charity care, discounts and/or payment plans for you.
- If you are sick, but not COVID 19 sick, please use your virtual insurance benefits to avoid in person group settings, yet still get the needed attention for your ailments.
- BCBS and UHC announced they will waive member cost sharing for all COVID-19 treatment occurring from April 1st through May 31st, 2020. This waiver includes deductibles, copayments and coinsurance for in-network facilities and out-of-network emergencies. Additionally, this waiver will be applicable to all BCBS fully insured group plans, individual plans, Medicare and Supplement plans, however, Medicare Part D plans are excluded.
Special Enrollment Periods
BCBS, UHC and Humana are allowing for Group's to offer a Special Enrollment Period (SEP). This new enrollment period, an off cycle enrollment, is between March 30th and April 30th for a start date of April 1st or May 1st. This allows all groups to offer their group insurance plans to their staff that is not currently insured. This enrollment period also triggers the ability for those same employees to decline again and get insurance on the individual market with a SEP allowing them to become insured and access subsidized insurance, insurance with the tax credit, coupon.
Note, this Special Enrollment Period does not allow currently insured employees to change plans.
How do I access telemedicine and virtual benefits?
Each carrier has their own program. You can click below to learn about the main carriers tele-medicine options.
4. National General - AETNA
What happens if I can not afford my health insurance bill at this time?
Billing and making bills during this time is at the top of folks minds.
- For small groups there are payment options with the carrier to allow for up to 90 day grace periods. The first 30 days insurance is as normal, the next 30 days insurance is pending, and the next 30 days the account is on hold. The first 60 days happen automatically but we need to request the 60-90 days. If you think you can not make your payments, let's get ahead of it. Signal us.
- For individual plans you only have a 30 day grace period on your payment and then your policy will terminate. If you are think you can not make your payment we should look at getting a subsidy or transitioning to Medicaid. Signal us.
What happens if I am laid off and lose my health insurance?
Many employers are laying folks off or furloughing them at this difficult time. They are all coordinating it in a variable of ways. Below are the most common situations.
- Laid off or furlough with 100% paid health insurance for X amount of time, open to changing later
- Laid off or furloughed with the same or different contribution, the remainder comes from the employee via "check"
- Laid off or furloughed with no contribution, this would be a full move to continuation
In the 3rd option we are working with clients to look at individual insurance options which could be drastically lower cost yet still the same great benefits. You can learn more in these videos.
How can individual be better than group insurance at this time?
Depending on your income level and the loss of income in 2020 you and/or your family could qualify for a subsidy which is a coupon to purchase your insurance. Often these coupons cover the vast majority of your monthly cost, premium. In some situations folks are also able to have cost sharing which lowers your deducible and out of pocket maximums drastically. Contact us for more information and/or specifics on this.