You're Moving On.
What you need to know:

Introduction:

Leaving your job can be one of life's biggest challenges. Whether you’ve been laid off, you’re starting your own business, or retiring early, we want to make the transition easier for you. This section of the site will help you research your health coverage options – COBRA, Individual & Family plans, government support and HIPAA eligible plans. Using the information and resources below, we can guide you to a solution that works best for you.

COBRA

If you work for a company of 20 full-time employees or more, you may qualify to extend your employer's health coverage through COBRA for a limited time – usually 18 months. Typically, your COBRA monthly premium equals your current monthly premium plus your employer’s share plus an additional 2% fee.
Tell me more about COBRA.

Individual & Family Plans

All health plans are not created equal. Before you sign up for COBRA, be sure to check out Individual and Family plans - you might be surprised at what you find. In a competitive market, they may often provide similar coverage and be far less expensive.

Please note that Individual & Family plans typically require a review of your medical history to qualify. You should consider waiting until you have received approval for the Individual or Family plan before declining continuation coverage, such as COBRA or a HIPPA Eligible Plan. This way, you can avoid having a gap in coverage.
Tell me more about Individual & Family plans.

Government Assistance

Government programs like Medicaid which covers adults and their families and CHIP which covers children can help you if you have a low income or are disabled.
Do I qualify for government programs?

HIPAA Eligible Plans & State High Risk Pools

If you’ve recently exhausted your federal and state (if any) COBRA continuation coverage, you don’t qualify for Medicare or Medicaid, and can’t get coverage under any other plan, you may qualify for a HIPAA Eligible Plan or State High-Risk Pool plan. You pay a monthly premium that is generally higher than a comparable COBRA or Individual or Family plan premium, so explore your other options first.
This is my situation. Tell me more.


If you are 65 or older
, please view our Medicare information page.

 

COBRA:

  • Lets you keep your employer’s health coverage for up to 18 months
  • Available if you were laid off or involuntarily left a company of 20 full-time employees or more

How it works:

With a COBRA plan, you usually have to pay 100% of your plan’s costs plus an administrative fee of up to 2%. This means you pay what you paid as an employee, plus your employer’s share, plus up to an additional 2%.

So, for purposes of illustration, if:

You paid: $200/month
and your employer paid: $800/month
plus 2% administrative fee: $20/month

Your COBRA payment would be:  $1,020/month

Extended COBRA Coverage

If you have certain disabilities, you may be able to add another 11 months for a total of 29 months of coverage.

State Extended COBRA Coverage

Some states provide for an extension of COBRA coverage after you’ve exhausted your federal coverage. The length of the state extension may vary from state to state. To find out if this extended COBRA coverage is available in your state, contact your state department of insurance.

Next Steps for COBRA:

  • Talk to your employer to find out what the cost of your COBRA coverage will be.
  • Find out if you qualify for any federal government assistance for COBRA coverage. Learn more here.
  • Explore your Individual & Family plan options to see if there is a plan that would be better for you than COBRA. Learn more

Individual & Family Plans:

  • Give you more options
  • May save you money

How it works:

Individual & Family health coverage is coverage you buy on your own. It can often provide similar coverage as your current plan at a competitive price. You pay monthly premiums to a private health coverage company like Anthem Blue Cross and Blue Shield. Individual and Family plans provide many coverage and price options which may be a better fit for you than COBRA.

Individual & Family plans may include health, dental, vision, and life coverage.

We recommend that you examine your options carefully – Individual & Family plans typically require a review of your medical history to qualify. Before declining continuation coverage, such as COBRA or a HIPPA Eligible Plan, you should consider waiting until you have received approval for the Individual or Family plan to prevent a gap in coverage.

How to Find the Best Plan...for You.

You need a plan that fits your budget, health risks and life situation. To find the best plan to protect you and your family, you should compare several and ask yourself these questions:

  • Premiums: How much will I pay each month to keep the plan?
  • What specific services do I need and will they be covered?
  • Which plan includes the greatest number of my preferred doctors and hospitals?
  • What will my “out-of-pocket” costs be? These are costs you are responsible for in addition to your premiums. These costs could include:
    • Copay – A flat fee (such as $20) that you may be asked to pay each time you see a doctor, fill a prescription or receive services
    • Deductible – The amount you must pay each year before your plan pays anything. Not every plan has a yearly deductible. Does the plan waive the deductible requirement for any preventive care and office visits?
    • Coinsurance – The percentage of medical costs you pay after meeting your plan’s deductible
    • Out-of-Pocket Maximum – The most out-of-pocket you could pay in any given coverage year before your health plan covers 100% of your allowable costs

 

When reviewing your dental, vision, and life coverage options, consider the following:

  • Dental coverage: Regular dental checkups can help detect the early warning signs of certain health-related issues – not just problems with your teeth. That's just one reason why it's so important to take good care of your teeth and gums. Having dental coverage can help make it easy.
  • Vision coverage: Even if you have great vision, routine eye exams are still necessary. Early detection of other health conditions can be discovered by doctors during your eye exams, so eye exams are not just for your eyes, but your overall wellness. With vision coverage you’re less likely to delay taking care of your vision health – and overall health.
  • Life coverage: Since you don't know what the future might bring, you can begin to prepare for the unexpected. Life coverage can be a gift of financial reassurance to your family.

Finding Answers for You is Our Legacy

Since its beginnings in 1933 assisting with hospital costs for Texas school teachers and establishing physician care for Northwestern lumber and mining workers, Anthem Blue Cross and Blue Shield plans across the country have led the way helping people get the medical coverage that meets their needs. At Anthem Blue Cross and Blue Shield, our professional, trained agents can help you compare plans and find the best one to protect you and your family.

Health Care Reform

The recently passed Patient Protection and Affordable Care Act will have immediate and long-term impacts on the choices and assistance available to you and your family for health care. We’re prepared to help you navigate any changes that result from the legislation. You can learn more about the Patient Protection and Affordable Care Act and how it may affect you here.

Next Steps for Individual & Family Plans:

  • Look at Individual & Family plans.

  • See why Anthem Blue Cross and Blue Shield is a good choice for you and your family: Go
  • Find out if you qualify for government assistance through Medicaid or CHIP.
    Learn more.

Government Programs:

  • If you are low-income or disabled, you and your family may qualify for Medicaid, which provides low-cost health care.
  • If you don’t qualify for Medicaid but are low-income, your children could qualify for CHIP, which provides low-cost health care to children.

What is Medicaid?

Medicaid is a state-run program that provides low-cost health care to you or your family if you meet its low-income requirements. Most states’ Medicaid programs have their own names, like Healthwise or MediCal.

How do I qualify?

In general, qualification for Medicaid is based on your income in comparison to the federal poverty level (FPL). Since each state runs its own program, whether you qualify will depend on the state’s rules and requirements. For example, in a certain state, you might qualify if your income is at or below 150% of the FPL.

Income isn’t the only factor used. Here are some other factors that states consider for Medicaid qualification:

  • Are you are a legal resident of the state where you want to receive Medicaid?
  • Do you have a savings account, a car, or other assets?
  • Do you have children?
  • Are you pregnant?
  • Are you or is someone in your household disabled?
  • Are you or is someone in your household blind?
  • Are you 65 or older?

What does Medicaid cover?

Medicaid covers most common health care costs. It even covers Medicare premiums, deductibles and co-pays if you are over 65 or disabled. Again, because Medicaid is a state-run program, the coverage you receive can vary. If you qualify, Medicaid programs cover everyone in your family.

State Children’s Health Insurance Program (CHIP or SCHIP)

If you don’t qualify for Medicaid, but still have a low income, you may find that your children qualify for CHIP - low-cost health care coverage for children of low-income families. This program can be referred to as either “CHIP” or “SCHIP.” Like Medicaid, CHIP Programs are state-run, so program qualifications and coverage will vary by state. CHIP programs usually go by different names in each state as well: for example, Healthy Families in California.

Why might I qualify for CHIP but not Medicaid?

CHIP targets assistance to children of families whose low incomes are slightly higher than the low-income requirements for Medicaid. Unlike Medicaid, CHIP only covers children age 18 and younger, not your whole family.

For example, to qualify for Medicaid in a certain state, your income may need to be at or below 150% of the Federal Poverty Line (FPL), but CHIP may cover your children if your income is between 151% and 250% FPL.

Tell me more about the Federal Poverty Line (FPL)

Next Steps for Government Programs:

  • Do I qualify for Medicaid? Do I qualify for CHIP? Contact the Medicaid/CHIP program in your state
  • If you’ve recently exhausted your COBRA continuation coverage, don’t qualify for Medicare or Medicaid, and can’t get coverage under any other plan, learn about HIPAA Eligible Plans: Go

HIPAA Eligible Plans & State High-Risk Pools

  • If your options are limited, you may qualify for a HIPAA Eligible Plan or State High-Risk Pool plan.

What are HIPAA Eligible Plans & State High-Risk Pools?

Federal law requires all states provide coverage for qualifying individuals who have recently exhausted their COBRA continuation coverage, don’t qualify for Medicare or Medicaid, and can’t get coverage under any other plan.

This Federally mandated coverage is provided either through a HIPAA Eligible Plan offered by health coverage companies, or through a State High-Risk Pool plan in which the state runs the plan. Depending on the state you live in you’ll have one choice or the other, or possibly both options.

How they work

Here’s how the plans work and what they cover:

  • You pay a monthly premium that is generally higher than a comparable COBRA or Individual or Family plan premium
  • You receive benefits similar to other health plans

How do I qualify for a HIPAA Eligible Plan?

If HIPAA Eligible Plans are available in your state, may be entitled to one of these plans if:

  • You had health coverage for at least 18 months without a break in coverage greater than 63 days.
  • Your most recent health coverage was under a group health plan.
  • You are not eligible for coverage under any of the following plans:
    • A group health plan
    • Federal COBRA continuation coverage
    • State COBRA continuation coverage, if available
    • Medicare
    • Medicaid
  • You do not have any other health coverage
  • Your most recent health coverage was not terminated because of fraud or nonpayment of premiums

How do I qualify for a State High-Risk Pool plan?

If High Risk Pool Plans are available in your state, please note that qualifications vary from state to state.

For more information and to find out if HIPAA Eligible or State High-Risk Pool plans are available in your state, and if you qualify, please contact your state department of insurance.

Next Steps for HIPAA Eligible Plans & State High-Risk Pools:

  • Learn more about these plans by contacting your state department of insurance.
Need help choosing the right plan?
Talk to one of our agents:
(888) 630-BLUE (2583)
Or shop for Individual & Family
plans online:

Additional Resources:

United States Department of Labor
FAQs for employees about COBRA continuation health coverage. www.dol.gov
Anthem Blue Cross and Blue Shield
Shop for Individual & Family coverage (self-service) www.anthem.com

Benefits.gov
A comprehensive listing of
government benefits
Medicaid programs by state:
www.govbenefits.gov
Kids programs:
www.govbenefits.gov
CHIP search results:
www.govbenefits.gov

 

InsureKidsNow.gov
CHIP programs by state www.insurekidsnow.gov

 

U.S. Department of Health & Human Services
Centers for Medicare & Medicaid Services Medicaid: www.cms.hhs.gov
CHIP: www.cms.hhs.gov