Health Care : Find Health Coverage After Losing Employer Provided Health Insurance

I lost my health insurance when I lost my job.  What help is available?

Facing the loss of health insurance is unsettling, and transitioning into new coverage options can be stressful.

To make the process a bit smoother, the Ohio Department of Insurance is helping Ohioans understand the different health insurance coverage options available in Ohio with an online toolkit of information available free from the Department of Insurance website.

I'm sick now and need help but don't have health insurance.  Are there any free clinics available?

Yes, find one in your area now.

Are there tax credits available that can help me pay my health care premiums?

The Health Coverage Tax Credit program is available through the end of the year for people who:

  1. Were laid off or lost their job to a foreign company
  2. Are 55 to 65 years of age and get their pension from the Pension Benefit Guaranty Corporation

What is Special Enrollment in Another Group Plan?

If other group health coverage is available, such as through a spouse’s employer provided plan, special enrollment in that plan should be considered.

However, to qualify, enrollment must be tested within 30 days of losing eligibility for other coverage.

This type of coverage is usually the most cost-effective of all the options.

What is COBRA coverage?

COBRA is a federal law providing for continuation of coverage for former employees of companies with 20 or more employees.

COBRA lets you continue the same policy, in some cases up to 36 months.

Ask if you are eligible for your employer’s Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage at the time you lose your job.

You have the right to continuation of individual and family health insurance coverage if you lose your job.

  • If you have pre-existing health conditions and are eligible, you cannot be turned down or charged more due to your health conditions.

  • • Employers should send you a COBRA notice. You then have 60 days to elect the coverage.

  • For workers who were involuntarily terminated between Sept. 1, 2008, and Dec. 31, 2009, the federal government will subsidize 65% of their premiums under COBRA for up to 9 months beginning March 2009.

  • To receive the subsidy, participants must attest that their same-year income will not exceed $125,000 for individuals and $250,000 for families.

  • Mini-COBRA coverage Ohio law provides those who were employed by small companies with 2 to 19 employees have the right to continue coverage under a group plan for up to 12 months.

  • Employers should send you a state continuation coverage (mini-COBRA) notice.

  • For workers who were involuntarily terminated between Sept. 1, 2008, and Dec. 31, 2009 and who are eligible for state continuation coverage, the federal government will subsidize 65% of their premiums for up to 9 months beginning March 2009.

  • To receive the subsidy, participants must attest that their same-year income will not exceed $125,000 for individuals and $250,000 for families.

  • HIPAA coverage - If you are not eligible for COBRA or when COBRA expires, but you have had 18 months of continuous group health coverage where the most recent coverage was under an employer group health plan, you are considered “Federally Eligible” for a Health Insurance Portability and Accountability Act (HIPAA) plan. The 18 months could be a combination of any creditable health coverage, including Medicare.

  • You need to apply for either the “Ohio basic” or “Ohio standard” health plan within 63 days of losing your previous coverage. Individual coverage Individual means the insurance is not connected to an employer plan. Individual plans are medically underwritten. Companies can decline you based on your health or attach exclusions to your policy. Costs vary so shop around and also consider working with an insurance agent.

  • Open enrollment - If you are unable to secure coverage through the normal enrollment process, you may be able to get coverage through open enrollment, which is conducted on a first-come, first-served basis.

  • Applicants are accepted until each Health Maintenance Organization (HMO) and traditional insurer reaches a statutory quota. Coverage secured during open enrollment can be expensive.

  • High-deductible major medical policy - Higher deductibles usually mean lower premiums. By combining a Major Medical plan with a Health Savings Account, you spend pre-tax money on your smaller health bills and use the Major Medical plan for catastrophic expenses.

  • Short-term insurance - You can generally take these out either on a month-to-month basis or on a term of six to 12 months. Even though this doesn’t cover pre-existing conditions, it may cover unexpected or acute conditions, for example, a broken leg.

  • Discount health plans - These plans are not insurance products; instead, they discount services provided by certain physicians, hospitals and pharmacies. If insurance is unaffordable to you, a discount health plan may serve as an option to lower your costs in certain situations. Be certain to read the membership agreement.

  • Professional organizations and association plans - Sometimes local associations such as chambers of commerce and professional groups offer health insurance. Coverage may also be available through a religious or fraternal organization. Tips:

What should I know about buying health insurance?

Make sure you talk with an insurance agent and comparison shop before you buy anything.  Also:

  • Call around and ask questions.Know that premiums for similar products can vary.

  • If you are healthy, don’t assume you can go without insurance.

  • If you are without coverage: ask your doctor about a payment plan, don’t visit the doctor for non-essential reasons, switch from brand name to generic prescription drugs and check for free medication samples.

  • Contact your physician, drug manufacturers and the State of Ohio to learn of prescription drug patient assistance programs. Call 1-877-794-6446 for more information.

  • Contact the Ohio Department of Insurance at 1-800-686-1526 with any insurance questions and to request informational materials.  Be sure to visit www.insurance.ohio.gov for additional information.

  • Contact the Ohio Department of Job and Family Services at 1-877-852-0010 if you are unemployed and without coverage.

Ohio Department of Insurance Contacts:

  • Robert Denhard, Public Information Officer (614) 644-3366

    Jarrett Dunbar, Public Information Officer (614) 644-2475

The information in this site is not intended as legal advice.
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