Understanding Your Health Insurance Options After COBRA Ends

What is COBRA?

 

The Consolidated Omnibus Budget Reconciliation Act, also referred to as COBRA, allows an employee and their eligible dependents to maintain their current health benefits after the employee loses access to their employer-sponsored plan. This usually happens as the result of a layoff or reduction in hours, impacting their qualification for employer-sponsored coverage. While COBRA premiums are higher than employer-sponsored plans, many families enroll in the program to keep their existing levels of coverage. However, there are limitations to the length of time an individual or family can retain COBRA coverage. Once eligibility ends, or if an individual or family is looking for a more affordable health plan, they will need to find health insurance after COBRA to keep themselves and their families covered.

How Long Does COBRA Last?

 

COBRA coverage lasts 18 or 36 months, depending upon the qualifying event. If eligibility was triggered by job loss or reduced hours, COBRA coverage can last up to 18 months from the date of the event. 

 

If eligibility was triggered by job loss or reduced hours AND the employee became eligible for Medicare within 18 months of the qualifying event, their spouse and dependents can be covered by COBRA for up to 36 months from the date they became Medicare eligible.

 

If the employee became eligible because of a different type of qualifying event, like divorce, COBRA coverage can last up to 36 months from the date of the event.

 

 

Health Insurance Options After COBRA Runs Out

 

The loss of COBRA can be stressful, but there are other health insurance options for individuals and families, including those impacted by unemployment:

 

  1. Health Insurance Marketplace Plans: The Health Insurance Marketplace, established by the Affordable Care Act (ACA), offers a variety of plans from private insurers. Plan premiums may be partially or fully subsidized by the federal government, depending on income. You can shop for plans during the annual Open Enrollment Period, or during a Special Enrollment Period (SEP) triggered by a qualifying life event such as the end of COBRA coverage, marriage, birth of a child, or loss of other health benefits.
  2. Medicaid: Medicaid is a state-funded program that provides health coverage to eligible low-income individuals and families. Eligibility criteria vary by state, but if you meet the income and other requirements, Medicaid could be the right option. 
  3. Medicare: If you're 65 years of age or older, you may be eligible for Medicare, a federal health insurance program. Medicare consists of different parts that cover hospital insurance (Part A), medical insurance (Part B), and prescription drug coverage (Part D). You can apply for Medicare during the annual enrollment period or as you near your 65th birthday.
  4. Limited Duration Insurance: Limited duration plans provide temporary coverage for individuals and families that may not qualify for a health insurance subsidy. These plans may have lower monthly premiums, but typically offer less comprehensive coverage and may not cover pre-existing conditions.

 

Is Losing COBRA Coverage a Qualifying Life Event?

 

Losing COBRA coverage is a qualifying event for ACA Marketplace plans if you’ve reached the coverage term length. The Special Enrollment Period to find another health plan lasts for 60 days following the last day of COBRA coverage. However, the loss of COBRA is not a qualifying event if you cancel before the end of the COBRA term maximum, or fail to pay the monthly premiums on time. In this case, you will have to wait until the next open enrollment period to enroll in a health plan through the Health Insurance Marketplace.

 

 

What to Do When COBRA Runs Out

 

It’s important to act quickly if you need health insurance after your COBRA coverage ends. You only have 60 days to enroll in a Health Insurance Marketplace plan under the Special Enrollment Period, starting from the date you lost COBRA coverage. To find the best options for your needs, leave plenty of time to research health plans. 

 

While you can qualify for Medicaid at any time, a lapse in coverage means you will not be covered if you need care. Any costs accrued when you are without coverage would be your responsibility.

 

No matter which option works best for your situation, choosing a plan before your COBRA benefits end is important to ensure you keep yourself and your family covered.

Shop Plans

If your COBRA coverage is ending, explore the individual and family health insurance plans available through Anthem to find the right option for your needs and budget.

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