If you’re like most working Americans, you know what it means to have insurance coverage through an employer. And you might even assume that the traditional group coverage that companies have provided for years is the only type of insurance a business has to offer. But in today’s ever-changing healthcare and insurance environments, and at the direction of a few federal health plan initiatives, employers have many more options.
In fact, your employer might be leveraging one of these many coverage applications, demonstrating there can be more available than just the old, traditional group plan. So if your job is providing something new, or you’re facing a lapse in coverage, here are a few additional options for health insurance you might now have available to you.
1. Non-Group Coverage Options Through Your Employer
There are some health insurance-related benefits that don’t work like a traditional group plan at all. Your employer might now be able to help you cover medical costs or bridge coverage gaps between jobs. Here are three coverage options you might have available to you.
Many companies have transitioned away from the expensive group plans and are now embracing Individual Coverage Health Reimbursement Arrangements (ICHRA.) These plans require participating employees to enroll in outside health insurance coverage and then submit receipts for reimbursement. This model is increasing in popularity among employees since copays, out-of-pocket healthcare costs, and even monthly insurance premiums (in some cases) are directly reimbursed.
If you experience a job loss, you will have access to Consolidated Omnibus Budget Reconciliation Act (COBRA) coverage. In these scenarios, terminated employees can choose to remain a part of the company’s chosen health plan to help bridge the gap of coverage. Those costs, however, will likely be more expensive than many of the other available insurance options out there.
Smaller businesses, with fewer team members on the payroll, can offer the Qualified Small Employer Health Reimbursement Arrangement (QSEHRA.) This HRA platform allows budget-constricted companies to offer some method of reimbursement for out-of-pocket healthcare costs. If you’re working with a company that is now offering a QSEHRA platform for employees, you may have reimbursement options available to you.
2. Coverage from the Private Market
Instead of enrolling the entire organization into one group plan, your employer may instead offer ways for you to leverage the private health insurance market. Reimbursement models may exist, allowing you as the individual to seek health insurance coverage elsewhere. Here are a few options you have in the private sector that may fit your budget and plan needs.
If you no longer have a traditional group health insurance plan available, you can explore the private health insurance market for coverage. Contacting providers directly, like Aetna or Blue Cross Blue Shield, will help you identify various plans that provide the coverage you need. However, enrolling directly with a provider might not offer the same cost savings afforded by those who instead browse the ACA Marketplace.
Many Americans find themselves with a gap in insurance. Whether it’s because you’re falling off your parents’ plan as a student or are between employer-sponsored plans, short-term coverage health insurance may be the best fit. These plans, as the name implies, are designed to cover for a fixed period of time and can be relatively affordable even if you’re paying out of pocket for those premiums.
A robust group health plan is essential for many individuals and families. But for the young adults or those who believe to be in good overall health, a high-deductible insurance plan may be the best. The premiums for these types of plans are usually very low, making them incredibly affordable. But remember, high deductibles mean, if you become unhealthy or in need of procedures, the cost burden might be significant for you.
3. Federal & State Sponsored Coverage Options
The federal government has outlined a few health insurance provisions to meet the growing needs of individuals and some families who might not be able to afford a private market plan or have the traditional group health plans through employers. Eligibility requirements exist for these types of government-sponsored programs based on age, health, and household income levels. You may find great coverage, with significant cost savings to you, with one of these programs.
The pandemic changed the household, financial, and insurance scenarios for millions of families. Medicare, a government program designed to help those with coverage post-retirement age, is now available to a broader margin of participants. These COVID-relief provisions mean you might now be eligible to enroll in Medicare.
Usually available to individuals and families below a particular income level, Medicaid and CHIP programs provide health insurance benefits to many Americans. These eligibility requirements were also loosened as a result of the pandemic, making it easier for anyone caught in the coverage gap to apply and enroll.
The ACA Marketplace
If you’re in between health insurance plans, have lost your job, or are experiencing a qualifying life event, you can always browse for health insurance plans via the ACA Marketplace. Any participating providers have to abide by federal guidelines. And enrolling through the Marketplace means also leveraging additional cost savings in available premium tax credits. These tax benefits have also been infused with COVID relief funding, meaning many Americans find coverage right now for less than $100 per month. And while the ACA tries to simplify the browsing, tax credit application, and enrollment processes, it can still be challenging to decipher, especially if you’re new to the Marketplace. This is where FREE services from W3LL can help.
Don’t be alarmed if the traditional group health insurance plans you’re used to start going away. There are new plans, revamped coverage, and plenty of insurance options available to you. Regardless of your job status or income levels, there is likely a health plan to fit your needs. And when you’re facing an ICHRA model or are interested in exploring the ACA Marketplace options, let W3LL help! Browsing and enrolling with our assistance is absolutely free, and we make it easy to find the best coverage you need.
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