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Published on April 21, 2020

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Losing Your Job Is Tough, You Don’t Have to Lose Your Health Insurance

By Deb Muller

In the early 1980s, my family struggled to keep the family farm. Interest rates were over 20% and year-over-year losses on the farm left us all wondering if we would be able to keep going. Even with all these pressures, and a child with a significant health condition, health insurance had to be a budget priority. They did not have the benefit of the Affordable Care Act to help them with the cost of their premiums and reduce their out of pockets when they filled a prescription, visited their physician or received outpatient care.

Today, many families and individuals are experiencing those same trade-offs as workers face the loss of their employer-based coverage in addition to the loss of their job. And yet today, there is hope that the loss of employment does not have to mean the loss of your family’s peace of mind when it comes to health care coverage.

The Affordable Care Act provides health insurance coverage through private insurers at reduced premiums for those who qualify based on income and household size. The federal government helps to provide that reduced premium by providing advance premium tax credits. So you receive the premium assistance right away.

Let’s take a family of four where their household income for 2020 is now expected to be $50,000. This takes the income the household already earned to May 1 and adds to it the unemployment benefits offered through the Families First Act and the state unemployment insurance program.

First, your two kids may be eligible for the CHIP program. CHIP is a state-run insurance program for kids and when you apply for a marketplace plan, the marketplace will send your information to the state to get the ball rolling on the children’s coverage.

Mom and dad will be eligible for $679 a month in premium credits AND they can receive reduced cost shares for care when they receive it if they select a certain plan level for coverage.

In going out to healthcare.gov, putting in this information for a family of four in Minnehaha County, I found out that mom and dad can get a family plan at the bronze level of coverage for just under $10 a month. They won’t receive the additional cost-share support — that happens on silver plans only — but with a bronze plan, they can get telemedicine visits at no cost-share during the pandemic. Moving to a silver plan with drug co-pays and a maximum family out-of-pocket of $4,600 for the year can be secured at $260 a month.

Every family and individual situation will be different, but they all share one thing in common: A clock ticking. You have only 60 days from the time of your layoff to apply for coverage. If you miss that window of opportunity, you will need to wait until January for your next open enrollment coverage opportunity on the marketplace.

Let’s get the word out. Call us at 1-855-MY-AVERA. Visit our website at AveraHealthPlans.com. Call a trusted agent.

Losing your job in a pandemic adds a whole level of anxiety in taking care of your family. Let us work with you to show you options that can help lessen that anxiety a bit.

Deb Muller is CEO of Avera Health Plans and DAKOTACARE.

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