What to do if Your Employer is No Longer Providing Health Insurance?
Health Insurance | 03 Jan 2023
Do you fear losing your employee-sponsored health insurance? You’re not alone in this concern, as many employees face the same issue as employers cease to offer health insurance benefits. But don’t worry, there are still affordable options for obtaining coverage.
If your employer is no longer offering health insurance, it can be a concerning situation. However, it’s important to understand that health insurance coverage is not required by law for all employers and some employers may choose to not offer it as an employee benefit. If your employer has discontinued the health insurance plan, there are several options available to ensure you continue to receive the coverage you need.
New Health Insurance Action Steps
Finding the right coverage for you and your family can be overwhelming, but taking the following action steps can help you get the health care you need.
Talk to your employer: Get in touch with your employer to see if they have any information about the transition or what will happen next.
Review your options: Consider whether you are eligible for Medicare or Medicaid, and consider enrolling in an individual health insurance plan on the marketplace.
Evaluate your needs: Consider your health care needs and determine the type of health plan that will best meet those needs.
Compare plans: Compare the benefits, services, and cost of several different health insurance plans to find the one that is right for you.
Enroll in a plan: Once you have selected the right health insurance plan for you and your family, enroll in the plan and start taking advantage of its benefits.
If you are stressing out over the insurance process and need a little help, Cover Kansas is here to help. We have experts to walk you through each step of process if your employer is not going to provide you and your family health insurance in 2023. These experts are called “Health Navigators,” they are located across the state of Kansas, and their services are 100% free.
Common Questions for Employees Who are Losing Their Health Insurance Benefits
The Affordable Care Act (ACA) requires large employers to offer health insurance coverage to their workers. However, employers with fewer than 50 employees are not required to do so. In fact, almost half of businesses with 3 to 49 workers do not offer health benefits to their employees.
If you work for a small business that does not provide health insurance, you have to find your own coverage. This gives you the opportunity to tailor a benefits package to meet your family’s needs and budget.
Cover Kansas navigators can help you choose the best health plan for your situation. Here are some key considerations to keep in mind when searching for your own health insurance:
Coverage Options: Many employees are concerned about losing their health insurance coverage when they leave their current job. To address this issue, employees can explore individual health insurance plans through the marketplace or through a private insurance company. Some employees may also be eligible for Medicare or Medicaid, depending on their income and other factors.
Plan Options: When choosing a new health insurance plan, employees should consider their personal health needs and the services that are important to them. They should also think about their budget and what type of coverage they can afford. It is important for employees to compare different plans and find the one that best fits their needs.
Medicare:Medicare is a federal health insurance program that provides coverage to people who are 65 or older, people with certain disabilities, and people with End-Stage Renal Disease. Employees who are eligible for Medicare should consider enrolling in this program, as it may provide better coverage and lower out-of-pocket costs than individual health insurance plans.
Medical Care Needs: Employees should think about the types of medical care they may need in the future, such as preventive care, specialist care, and hospitalization. They should also consider whether they want a plan with a low deductible or one with a higher deductible that offers lower monthly premiums. It is important to choose a plan that will provide the necessary care and support for their health needs.
Medicaid:Medicaid is a joint federal-state health insurance program for low-income individuals and families. Employees who are losing their health insurance benefits and have low incomes may be eligible for Medicaid. Check with KanCare, the state’s Medicaid program administrator, to see if they qualify for this program.
Service: Employees should look for a health insurance plan that offers good customer service and a user-friendly website. They should also make sure the plan has a network of doctors and hospitals that they can use for their medical needs. A plan with good customer service and a wide network of providers can provide peace of mind and help employees get the care they need.
Individual Coverage: Individual health insurance plans are designed for people who are not covered by an employer-sponsored plan. Employees who are losing their health insurance benefits can explore individual plans to find the coverage they need. They can compare different plans and find the one that provides the best combination of coverage, cost, and service.
Family Plans: Employees who have a family should consider their family’s health needs when choosing a new health insurance plan. They should look for a plan that provides coverage for all family members, including children, and that offers services such as preventive care, specialist care, and hospitalization. They should also compare plans to find the one that provides the best value for their family.
The Marketplace: The Health Insurance Marketplace is a government website where individuals can compare and enroll in health insurance plans. Employees who are losing their health insurance benefits can use the marketplace to find a new plan that meets their needs. The marketplace offers a range of plans, from basic coverage to more comprehensive plans, and provides information on financial assistance that may be available to help with the cost of coverage.
Benefit: Employees who are losing their health insurance benefits should consider the benefits of having health insurance, such as access to preventive care, specialist care, and hospitalization. Having health insurance can also provide peace of mind and help protect their financial stability in case of a serious illness or injury. Employees should find a plan that provides the coverage they need and the benefits they want.
What are your options if your employer is no longer providing health insurance benefits?
If your employer is no longer providing health insurance benefits, you have several options to ensure you have access to quality healthcare coverage.
Firstly, you can consider enrolling in an individual health insurance plan through the marketplace or a private insurance company.
Another option is to check your eligibility for Medicare or Medicaid, which can provide coverage based on your income and other factors.
When choosing your health insurance coverage, it’s important to consider your personal health needs and budget, and to compare different options to find the one that best fits your needs. Make sure to keep your options open and research the different types of coverage available to you so that you can find the coverage you need for yourself and your family. Some things to keep in mind:
Premium subsidies could make your individual health insurance very affordable. In the individual market for comprehensive health insurance, premium tax credits (premium subsidies) established by the Affordable Care Act might pay a substantial portion of the monthly cost of the health plan. Depending on your income and the plan you select, it’s possible that the subsidies might cover the full cost. And the subsidies are larger and more widely available than they used to be, thanks to the American Rescue Plan (ARP).
Silver plans can further reduce your insurance costs. Pay particular attention to Silver plans if your household’s income isn’t more than 250% of the poverty level (that’s $66,250 for a family of four enrolling in coverage for 2022). Income-based cost-sharing reductions will make your coverage more robust, but they’re only available if you choose a Silver plan. Cost-sharing reductions are particularly strong at incomes up to 200% FPL – and Silver plans are now available free at incomes up to 150% FPL and at a much lower cost than previously at incomes above that level.
You can use a health savings account. If you’re interested in contributing to a health savings account, you’ll need to purchase an HSA-qualified high-deductible health plan.
Consider your provider network when you compare plans. If it’s important to you to have specific doctors in the plan’s network, or specific medications covered by the plan, pay close attention to the provider network and the formulary (covered drug list) of any plan you’re considering. These vary considerably from one plan to another. The federal health insurance marketplace (HealthCare.gov) allow you to check which plans specific doctors and hospitals accept.
You can buy additional coverage. If you want additional coverage beyond major medical, you can often purchase supplemental benefits.
Medicaid or CHIP might be available. Depending on your household’s income and where you live, Medicaid and/or CHIP might be available for at least some members of your household. These programs, provided by KanCare in Kansas, provide free or low-cost coverage with comprehensive benefits and low out-of-pocket costs.
How do you find an affordable healthcare plan that meets your needs and budget?
Looking for an affordable healthcare plan that fits your needs and budget can be a challenge. However, there are several ways to find a plan that works for you.
Firstly, you can take advantage of premium subsidies through the Affordable Care Act, which can make your individual health insurance very affordable.
Secondly, you can consider a Silver plan, which can further reduce your insurance costs, especially if your household’s income is within 250% of the poverty level.
Thirdly, you can consider using a health savings account to contribute to your medical expenses.
Additionally, it’s important to compare provider networks and formularies of different plans to make sure they meet your specific needs. You can also consider purchasing additional coverage beyond major medical, such as supplemental benefits. Lastly, you might be eligible for Medicaid or CHIP, which provides free or low-cost coverage. By considering these options, you can find an affordable healthcare plan that meets your needs and budget.
Here are a few articles that might help you in this process.
What should you do if you can’t afford to purchase a healthcare plan on your own?
If you’re unable to purchase an individual health coverage plan due to financial constraints, there are alternative options available.
Firstly, it’s important to check if you’re eligible for Medicaid through KanCare, a government-funded healthcare program for low-income individuals and families. If you’re over 65, you may also be eligible for Medicare, a federal health insurance program for seniors.
Additionally, you can explore coverage options on the marketplace, which offers different plans and services to individuals and families with varying budgets. It’s crucial to find a plan that fits your needs and budget, and provides the benefits you require for proper healthcare and care.
What should you do if you’re struggling to pay for medical expenses or prescription drugs?
If you are facing difficulty paying for medical expenses or prescription drugs, it is important to find alternative options for coverage.
One solution is to check if you are eligible for Medicaid or Medicare, which can provide affordable healthcare services for individuals and families in need.
Another option is to explore the individual marketplace, where you can find a health insurance plan that meets your needs and budget.
Additionally, it may be helpful to research prescription drug assistance programs or negotiate payment plans with medical providers.
Some medications may be cheaper at another pharmacy. If you have health insurance, check with your insurance provider to see if your plan has a preferred pharmacy where your benefit may be better. You also may be able to save money by requesting a 90-day prescription or using a mail-order service.
Your provider may be able to switch your medication to a generic and/or cheaper alternative.
Find a health clinic or pharmacy with a 340B prescription drug discount. The 340B prescription drug discount program allows eligible healthcare organizations to access discounted prices on prescription drugs, helping to reduce the cost of care for patients and improving access to essential medications.
Drug discount cards, such as GoodRx, can help you save on prescriptions. You can find discount cards and participating pharmacies online, or ask your pharmacist.
Manufacturer coupons and copay cards: Some drug companies offer discount coupons to patients with commercial insurance plans. Medicare and Tricare plans are excluded from copay cards.
Medicare’s Extra Help program: If you have Medicare, you may be eligible for extra help with prescription costs. Call (800) MEDICARE (633-4227) to find out if you qualify.
Patient assistance programs: Some drug companies have assistance programs that may offer prescription drugs at little to no cost, depending on eligibility. If you have run out of other options, ask your provider or pharmacist if you qualify for any assistance programs. You may be able to apply through the drug manufacturer’s website.
Navigators can help with enrollment in the right plan to meet an individual’s medical needs and budget. They provide guidance to individuals in finding and comparing health insurance options, and help answer any questions they may have. Navigators are trained and certified to help individuals understand their options and enroll in the best plan for their needs. They can also help with ongoing support and maintenance of coverage.
If you’re in need of assistance with your health coverage, a Health Insurance Navigator can help provide the information and support you need to find the right plan for you and your family.
Cover Kansas is network of certified navigators across the state of Kansas and has specialists available now to help people and families who don’t have insurance coverage through their job. We will guide you through the Health Insurance Marketplace and help in making decisions for health insurance coverage.