Your Pandemic Health Insurance Questions Answered

Wondering what will happen if you get sick is a universal concern. In 2018, it was also the top concern for over 40% of the 1,200 freelancers surveyed by Fiverr. A pandemic further heightens the urgency of understanding your options to get the best care possible. Last week, we reviewed six health insurance options for freelancers. Today, in our second installment, we offer our take on your top questions about finding, getting, and paying for health insurance as a freelancer during the pandemic.

Can I buy health insurance?

Maybe. Here in America, where I am writing this, our very interesting healthcare system generally allows you to buy health insurance in two situations.

1.     If you have a Qualifying Life Event that affects your existing health insurance in a major way. Examples include: changing jobs, losing your existing health insurance, moving, or having a baby.

2.     If it is a Special Enrollment Period. Usually this runs from mid-November until December or January, depending on your state, but right now eleven states and the District of Columbia have opened a new Special Enrollment Period in response to the coronavirus. If you live in one of these places, you should be able to buy health insurance right now whether or not you have a Qualifying Life Event.

If neither option applies to you, you might still be eligible to buy a health insurance alternative, like a medical cost sharing plan from Knew Health or qualify for low-income health insurance from Medicaid and CHIP. These services allow enrollment year-round.

What are the different kinds of health insurance I can buy?

There are a lot of different health insurance coverage structures, each with its own three letter acronym, so it is important to understand what you’re getting. These are the most common ones from broadest to narrowest coverage: 

1.     PPO: A “preferred provider organization.” This is the most flexible type of health insurance, since it pays for both in-network and out-of-network doctors, though in-network doctors are cheaper. It also lets you visit specialists and have lab work done without a referral.

2.     POS: A “point of service” policy. This insurance pays for both in-network and out-of-network doctors, but you can only visit a specialist or have lab work done if you get a referral from your primary care physician. 

3.     EPO: An “exclusive provider organization”. A little less flexible than the PPO, an EPO also lets you visit specialists without a referral, but you will pay the full cost yourself if you visit an out-of-network doctor. 

4.     HMO: A “health maintenance organization.” This coverage is much less flexible, since it pays for services from in-network providers. You will pay the full cost yourself if you visit an out-of-network doctor. Further, you can only visit a specialist or have lab work done if you get a referral from your primary care physician.

Each type of insurance (PPO, HMO, etc.) has something called “metal tiers” that range from bronze to platinum. These specify how much of your healthcare costs the insurance plan will cover. Bronze is the lowest tier. It has the cheapest monthly payments, since you promise to pay more of your healthcare expenses out of pocket. It can be a good choice if you have relatively few ongoing medical expenses. Platinum is the highest tier. It has the highest monthly payment, but it pays a much greater percentage of your medical expenses. This is usually the better option if you anticipate needing more medical care.

What happens to my health insurance if I lost my job?

It depends. If you got health insurance through your job and are now losing that coverage, this will most likely count as a Qualifying Life Event making you eligible to buy new health insurance through the marketplace at healthcare.gov. If you lost your job, and you were not getting health insurance through it, you probably won’t have a Qualifying Life Event. In that case you’ll need a Special Enrollment Period or an alternative like health cost sharing or Medicaid to get new coverage.

What if my working hours were reduced?

If you get health insurance from your employer, check with them directly to see what options you have. If you’re already enrolled in a health insurance plan from the marketplace at healthcare.gov, you can update your income on their website here. You might be eligible for savings on your monthly payments.

What if I was furloughed?

First, check with your employer. Many employers are keeping health insurance benefits for workers they are placing on leave. If that isn’t the case for you, you may be eligible for a Special Enrollment Period so you can buy health insurance directly from healthcare.gov. Check here.

What if I have health insurance but can’t afford it anymore?

First, check with your health insurance provider. Many are offering extended grace periods for their members who cannot make their payments on time because of hardships from coronavirus, and are delaying cancelling coverage for nonpayment. For example, see here for Blue Cross Blue Shield’s press release last month. State laws usually require a grace period of one to three months in which the insurer cannot cancel your insurance for nonpayment. If your income has dropped substantially, you might be eligible for Medicaid instead. You can check here.

While you are checking on your health insurance, keep in mind that other insurers, including auto and life insurance, are also offering extensions and, in the case of Allstate, the possibility of missing up to two payments without penalty. You can find the full list here, including the grace periods by state.

Which health insurance is right for me?

See our previous post on the six health insurance options for freelancers with pros and cons of each.

What are your biggest questions now as a freelancer? Drop us a note in the comments or on social media and let us know what’s on your mind!

Thumbnail photo by Anna Shvets from Pexels.