Coronavirus: Health Insurance Options If You've Lost Your Job

Last Updated On: 5/8/2020 8:57:03 AM

I have Symptoms of COVID-19 and I think I should Get Tested, But I Lost My Insurance When I Lost My Job.  What Can I Do?   

As of March 26, 2020, in West Virginia you can get tested for no charge, even if you have no health insurance.  During the coronavirus emergency the West Virginia Medicaid Program will cover the cost of testing for people with no insurance at all.  

Dr. Cathy Slemp, West Virginia’s state health officer, said those without insurance or a doctor who are exhibiting symptoms of COVID-19 or fear they have been exposed could reach out to their local health department or a community health center for help.  Testing AND TREATMENT, will be available at no cost.

Don’t delay!  Please, get tested.  You need to know, so you can avoid infecting your family and friends. 

If I Get Tested and I Have COVID-19, I Don’t have Health Insurance to Cover the Treatment.  What Can I Do?

As of March 26, in West Virginia you can ALSO get TREATED for COVID-19 for no charge, even if you have no health insurance.  During the coronavirus emergency the West Virginia Medicaid Program will cover the full cost of testing AND TREATMENT for people with no insurance at all.  

If you are having symptoms of COVID-19 or fear you have been exposed, reach out to your local health department or a community health center for help.  Testing AND TREATMENT, will be available at no cost.

Again, please don’t delay because you worry about how to pay for it.  The best way we can control the coronavirus outbreak is for EVERYONE who has symptoms to get tested, and get treatment if they have it.  If you go through your county health department or a community health center, the costs will be covered by the Medicaid Program. 

What If I Have Other Health Problems, and I’ve Lost My Health Insurance? Can I Apply For Medicaid?

Medicaid is available in West Virginia to most people whose monthly income is below defined limits. Even if you were making too much money for Medicaid last month, if you meet the Medicaid limits this month, you can get coverage. If you have been laid off and your household monthly income is low enough you can apply immediately for Medicaid.

What Are the Income Limits for Medicaid?

  • 1 person: $1,387 per month
  • 2 person: $1,868 per month
  • 3 person: $2,348 per month
  • 4 person: $2,829 per month
  • 5 person: $3,310 per month
  • 6 person: $3,790 per month
  • 7 person: $4,271 per month
  • 8 person: $5,902 per month

If your monthly household income is lower than these figures, you should apply for Medicaid immediately.  

How Do I Apply for Medicaid?

WV DHHR has an online application process. Go to: https://www.wvpath.org/. You will have to start by setting up an “Optum GovID account.” Once you set up an account, you can submit your Medicaid application.

You can apply for Medicaid by phone. Call 1-877-716-1212. We do not know if the State has maintained full staffing for that phone line during the COVID-19 emergency.

You can apply for Medicaid in person at your local DHHR office. We do not know if the State has maintained full staffing to take Medicaid applications during the COVID-19 emergency.

DHHR has more online information for people who want to apply for Medicaid.

You can also apply for Medicaid through the federal www.healthcare.gov web site. If your income is below the Medicaid limits your information will be automatically sent to WV DHHR as a Medicaid application. We do not know how long that process will take during the COVID-19 emergency.  

If my high-deductible health plan covers COVID-19 testing and treatments, would I lose my health savings account eligibility?

Most likely your plan would still be eligible. If a health plan is eligible to be a high-deductible health plan (HDHP), it will not be disqualified solely because it provides medical services and item purchases related to testing for and treatment of COVID-19 prior to the paying of the applicable minimum deductible. Similarly, individuals will not lose eligibility for receiving COVID-19 testing or treatments. Individuals, and tax-favored contributions by employers on behalf of individuals, may continue to be made to a health savings account (HSA).

This exception is meant to provide flexibility to HDHPs to provide health benefits for testing and treatment without having to use deductibles or cost-sharing. Individuals should still consult with their particular health plan regarding testing and treatment of COVID-19, including the potential application of any deductible or cost-sharing mechanism. Vaccinations continue to be considered preventative care for determinations of whether a health plan qualifies as an HDHP.  

My spouse and I had health insurance through the federal Affordable Care Act “marketplace.” I lost my job because of coronavirus measures, but my spouse is still working. Can we get our monthly health insurance premiums reduced because of our change in household income? 

Yes. Anyone who already has marketplace coverage can return to the marketplace to apply for a re-calculation of their costs. Go to www.healthcare.gov.  

My spouse and I had health insurance through my job. I’ve been laid off but my spouse is still working. Can we get marketplace insurance now through the Healthcare.gov website?

Under the Affordable Care Act, people who lose health insurance coverage when they lose a job can go to the “marketplace” at www.healthcare.gov at any time to get health insurance. You do not have to wait until next year’s “enrollment period.”

But getting marketplace coverage due to sudden loss of income is more complicated. People who have had sudden loss of income must go through a different process to estimate future income based on current circumstances. You probably will have to provide documentation that you were laid off.

If your new household income is low enough, the federal marketplace will send your information to DHHR as an application for Medicaid. If your new household income does not qualify for Medicaid, you should be able to buy marketplace health insurance to replace your job’s health insurance. 

The federal government may make it easier for people who have lost health insurance because of the coronavirus COVID-19 to get emergency marketplace health insurance. That has not happened yet. Legal Aid will update this article if and when the President or Congress take that action.

Before this coronavirus emergency, I did NOT have health insurance. Because of the coronavirus emergency, can I go to the Obamacare Marketplace site now to buy health insurance coverage?

No. People can buy health insurance through the “Marketplace” only during a specific “open enrollment period” each year. The enrollment period to buy insurance for 2020 closed last December. The enrollment period for 2021 will not open until November 2020.

However, there are a few exceptions:

  1. You had health insurance coverage, but lost it:
    • Due to loss of job that carried health insurance
    • Due to divorce or separation that terminated health insurance
    • Moved to a different location where your old health insurance didn’t cover.
  2. You had a change in household:  
    • Got married 
    • Had a baby 
    • Had a death in the household
    • Gained a dependent

When any of these exceptions apply, you may have a “special enrollment period” to buy health insurance through the Marketplace anytime during the year. 

Because of the coronavirus emergency, some states who run their own Marketplace have allowed anyone to buy health insurance, even if they did not have health insurance previously. Most states, including West Virginia, use the federal health insurance Marketplace. The federal government decided NOT to open the federal Marketplace. Only people who meet one of the exceptions above are able to buy health insurance through the federal Marketplace during coronavirus emergency.
This is general legal information. For guidance about your situation, talk to a lawyer.