Q: Can I keep my health insurance after being fired?
Sincerely, Vocationally Impaired
$ ?s answered by Matthew Illian, CFP®
Dear Vocationally Impaired,
A pink slip can send you reeling. It is important to take care of some essential items while you regroup. Temporary health insurance should be a priority so you can search for a new job without the stress of being uninsured.
Assuming you were not fired for gross misconduct, most employer health insurance plans allow former employees to opt into COBRA for 18 months (although there are some exceptions allowing for a 36-month extension), but the cost is likely to shock you. COBRA allows you to stay on the company health insurance plan, but you lose your employer’s subsidy. If you thought the cost of health care was outrageous as an employee, just wait until you are left to pay the full bill.
Shortly after finishing your employment, you should receive a letter from the benefits office offering you the option to continue your health coverage under COBRA, and you have 60 days to make this election. COBRA is especially beneficial to those with higher than average medical costs who would get charged a lot to buy their own individual health insurance policy. Those who are healthy should look into lower cost individual health plans for comparison. Individual health plans are actually pools of other people in your state in a similar demographic.
You may want to consider using the pink slip as an opportunity to launch your own business. If so, I recommend pairing a high-deductible health plan (HDHP) with a Health Savings Account (HSA). A HDHP provides low-cost insurance and an HSA offers tax-preferenced savings accounts which help to pay for the routine expenses. Paired together, the HDHP and HSA a powerful long-term solution, whereas COBRA is only for a limited time.
Affinity group associations often offer an alternative for a self-employed individuals or 1099 contracted employees to access a group health plan. Unions, alumni associations, and various professional organizations are the first places to look. For example, writers have access to becoming a member of the Writers Guild of America and can join their group health plan.
If you don’t fit into any other associations, the National Association for the Self Employed offers access to group health insurance through several large carriers. This option will likely mean higher monthly premiums (and annual dues) but lower deductibles than an individual HDHP. Those with a preexisting health conditions will likely find lower costs through this pooled option than as an individual.
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Matt – why didn’t you also touch on aspects of the ACA that decouple job and health insurance? One of the great benefits of the ACA is severing the artificial link between health insurance and an employer.
Andrew- I wrote this column to address those who need a new health insurance option today. The new health exchanges will not be in place until 2014 and at this time the health insurance companies and the states are unsure about what these exchanges will look like. I’ll be sure to update this post as the upheaval in the health insurance field gets ironed out.