Dec. 12, 2023

This paid piece is sponsored by Avera Health.

At any moment in America, more than 65 percent of working-age adults are on the hunt for a new career. If this describes you, you may wonder how to continue health coverage if a job ends or you’re looking for something new.

“Gathering information — and knowing what it means — is the best way to make sure you’re making the best decisions on health coverage,” said Tara Stombaugh, director of consumer sales and client services with Avera Health Plans. “Letting coverage lapse is never a good decision.”

So what do you do to ensure you and your loved ones are covered? First, know your options:

• When you lose your health coverage because of a change in jobs, you qualify for a special enrollment period on the federal Health Insurance Marketplace at healthcare.gov.
• If your new employer or your spouse’s employer offers affordable coverage, that’s your best bet as the Marketplace does not offer you subsidies or tax credits if you are eligible for affordable insurance through your employer.

Almost every job you’ll land comes with a learning curve, and while you’re remembering where to park and who’s on your team, you also must learn the ins and outs of your health coverage.

Coverage varies from employer to employer as well as plan to plan. Learn all you can about your coverage and understand your out-of-pocket costs, which may include monthly premiums, deductibles, coinsurance or co-pays. Your employer may pay part or all of the monthly premium cost.

“If you’re more comfortable with higher out-of-pocket costs, a higher-deductible plan might be a better fit for you,” Stombaugh said.

With high-deductible health plans, or HDHP, you’ll have lower monthly premiums compared with traditional co-pay plans. A benefit of an HDHP is the fact you can put tax-free income into a health saving account, or HSA. That’s your money, and it can be used to pay medical expenses, rolled over to the next year or taken with you when you leave a job.

“Most employees with HDHPs have preventive care visits covered at 100 percent,” she said. “Employers may contribute to HSA funds too. That can encourage employees to select a plan with lower premiums.”

If you can’t afford your employer’s health insurance plan, you still have options. If the premium cost is more than an estimated percentage of your family’s income, you may qualify for tax credits to get a plan off the Health Insurance Marketplace at healthcare.gov. It’s fairly standard for the cost of employer plans to fall below the 9 percent income affordability index.

You’re not out of luck if your employer closes its doors or decides to downsize. Whether you quit or get laid off, coverage options include:

• Extending your existing coverage under the Consolidated Omnibus Budget Reconciliation Act, or COBRA. While expensive, COBRA coverage can be an option for coverage until you get a new job. COBRA may be important to you if you are undergoing treatment for a health concern.
• The Marketplace at healthcare.gov. When you lose your health insurance because of a job change, you qualify for a special enrollment period, making you eligible to go to the online Marketplace to find a new plan. You may qualify for subsidies and tax credits to help reduce premium costs. Open enrollment continues Nov. 1 through Jan. 15.
• State laws often require smaller companies — those with less than 20 employees — to provide continuing coverage, in addition to and beyond federal rules.
• Parent or spouse plans. If you’re 26 or younger, you may qualify for health insurance with your mom or dad’s plan, if they are covered by an Affordable Care Act-compliant family plan.
• Federal programs, such as Medicare — for people 65 or older or people with disabilities — and Medicaid, which can provide coverage to people who meet income guidelines. For states that have passed Medicaid expansion, including South Dakota, the income qualification is 138 percent of poverty level, or around $20,000 for one person.

Learn exactly when you will lose insurance coverage. Some employers extend it through the month; for example, if you leave your job Dec. 15, you may still be covered throughout the month of December.

“It’s worth doing the homework to ensure you have coverage going into the new year,” Stombaugh said.

Learn more about Avera Health Plans.