COVID-19: The New Health Insurance Reality
Disruptions to our daily lives have created confusion and uncertainty in the months following the onset of the global coronavirus pandemic. Due to the high volume of requests for clarification, on COVID-19: The New Health Insurance Reality, we’d like to go over the different impacts on health insurance coverage and enrollment opportunities for each of the individual segments of short term, ACA, Medicare Advantage, and Medicare Supplement plans.
Short Term Medical (STM) plans:
Typically available for terms of 1-12 months; often renewable without medical underwriting for two additional terms. Open to enrollment applications at any time. Limited coverage for preventive care or pre-existing conditions.
Many plans have waived cost-sharing for COVID-19 related testing and treatment. Some applications ask about possible exposure in the last 30 days.
Affordable Care Act (ACA) plans:
While some of the states that run their own health insurance exchange have established a special enrollment period due to coronavirus, nothing has changed in the rules for states like Georgia that use the federal marketplace.
Losing job-based health insurance is a qualifying life event that provides a 60-day window following the end of the employer group coverage to sign up for an ACA (Obamacare) plan. People facing a job loss situation should bear in mind that activating COBRA coverage would invalidate their opportunity to sign up for ACA coverage before the next Open Enrollment Period for 2021 coverage.
Insurance companies on the ACA marketplace, such as Ambetter, are waiving member cost sharing for telehealth services in order to support safe access to care.
Medicare Advantage plans:
There is a national Special Enrollment Period until June 30 for Medicare beneficiaries who otherwise had a valid enrollment period from January 1 to March 31 that they were unable to use. This could apply to people who turned 65 at the end of 2019 and were in the final 3 months of their Initial Enrollment Period or those currently enrolled in a Medicare Advantage who would have had Medicare Advantage Open Enrollment period to make one plan change in the first quarter. Please contact us to verify your eligibility.
Major companies have responded to COVID-19 by adjusting their coverage to help members. Humana, for example, has eliminated all copays on their Medicare Advantage plans through the end of 2020. More conservatively, UHC has eliminated cost-sharing for many out-patient services through September. Call us for more details on your insurance company’s response.
Medicare Supplement plans:
Cost-sharing leftover from Original Medicare is already covered by most Medicare Supplement plans. On plan types where there would otherwise be some member responsibility, a few companies like the AARP plans from UHC are covering the costs of COVID-19 testing.
Medigap enrollment opportunities are the same as always. After the 6-month Medicare Supplement Open Enrollment following your Part B effective date ends, your health history can determine rates or acceptance.
SENIOR BENEFITS OF GEORGIA
WEST COBB OFFICE
3880 Due West Road NW
Marietta, GA 30064
SENIOR BENEFITS OF GEORGIA
EAST COBB OFFICE
2050 Roswell Rd (Remax Building)
Marietta, GA 30062