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.
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.
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 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?
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.
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:
|and your employer paid:||$800/month|
|plus 2% administrative fee:||$20/month|
|Your COBRA payment would be:||$1,020/month|
If you have certain disabilities, you may be able to add another 11 months for a total of 29 months of 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.
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.
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:
When reviewing your dental, vision, and life coverage options, consider the following:
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.
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.
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.
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:
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.
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.
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.
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.
Here’s how the plans work and what they cover:
If HIPAA Eligible Plans are available in your state, may be entitled to one of these plans if:
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.
The Voice of Choice:
I have a family, and my daughter has special health needs. We explored Individual coverage, but found that COBRA would be our best choice.
We just got married. We’re about to turn 30. And I just lost my job. I talked to an agent and found that a Family plan was the best option for me and my wife. The plan I chose is similar to what I had at my job but I'm paying less than if I had COBRA. Good luck!
--Sheila & Jay
I couldn't believe it when I lost my job. We're having a tough time and I need to support my son and me. I did some research and found out that I could get government assistance through Medicaid and CHIP.
CHIP programs by state www.insurekidsnow.gov