Dear Friends,

Below is updated information on getting and keeping affordable health insurance since the appearance of COVID-19 in the United States. It includes some important information on extended enrollment periods. 

If You’re Uninsured

Some states opened their Affordable Care Act Marketplaces/Exchanges in the wake of the public health crisis so those who are uninsured could get coverage. The following states still have a COVID-19 Special Enrollment Period (SEP):

• California: through June 30
• New York: through July 15 

*Check state websites for updates!

Thirty-two states, including Florida and Georgia, rely on the federal government website www.healthcare.gov  to run their exchanges and will not open for enrollment. However, anyone who experiences one of the following life events qualifies for a Special Enrollment Period of 60 days from the date of the event: losing health coverage through a job or union, moving to another county or state, getting married, getting divorced, having a baby, adopting a child or a change in immigration status. This means that many who recently lost jobs and lost the coverage associated with them will be eligible to enroll, regardless of what state they live in.

COBRA

In addition, if you’re insured through your job or union and have recently lost coverage, you have 60 days to choose COBRA or enroll in other insurance. COBRA is a law lets you keep your employer or union-based coverage for 18 months (sometimes longer). However, you’re paying the full cost of your health insurance, and it’s often very expensive. Contact your employer or union’s HR or Pension and Health Department for more information on your costs. 

Lowering Your Premiums If You’re Already Insured 

If you’re covered by an Affordable Care Act Marketplace/Exchange plan, you can go back into your online account and change your income to reflect your current reality. For example, if you were laid off from your job in March and are now collecting unemployment, you should change your income estimate to reflect your gross income through the last day you were paid, and then add the total of your weekly gross unemployment benefit multiplied by the number of weeks you will receive it this year. Note that the federal government extended all unemployment benefits an additional 13 weeks. So for example, New York (and most other states) have a maximum of 26 weeks of unemployment benefits, but this year it was extended to 39 weeks. Don’t forget that if you’re self-employed, you’re eligible for benefits now as well. For more information on the different types of unemployment assistance available, visit the National Employment Law Project website. Do not include the $1200 pandemic stimulus check you received in your income estimate. Re-estimating your income may make you eligible for much higher tax credits and lower premiums. 

If You Have Little or No Income 

If you have little or no income going forward, regardless of your current insurance status, you may be eligible for Medicaid. Medicaid is comprehensive, free health insurance. It covers hospitalization, lab work, office visits, medication, surgery and many other benefits. There is no monthly premium and no deductible. Co-pays are low ($1 and $3) and generally apply to medications only. If you’re eligible, you’ll receive coverage for 12 months. In 37 states, including California, New York and Illinois, if you are under 65, you must show that your household income in the prior month only was below a certain threshold in order to qualify. For a single person, the prior month’s income (including unemployment and other income sources) must be below $1468 gross. For 2 people, it must be below $1983 gross. Please note that the Pandemic Unemployment Compensation (PUC) of $600/week does not count towards your income for purposes of applying for Medicaid. If you are under 65, Medicaid does not take assets, such as savings accounts, into account. To apply, visit www.healthcare.gov or your state’s Marketplace/Exchange. 

In 13 other states, including Georgia and Florida, the above Medicaid rules do not apply. In these states you must contact your state Medicaid office or a local Navigator to see if you qualify.  

In New York, you may be eligible for the Essential Plan. The Essential Plan is very comprehensive insurance available only in New York; there are no deductibles, the premium is $20/month and co-pays are low. Unlike Medicaid, the Essential Plan looks at yearly projected income. In order to qualify for it, your income so far this year, and any income you expect going forward (such as unemployment), must be below $25,520 gross (single person) or $34,480 gross (couple). 

Medicaid and the Essential Plan are insurance programs that you should seriously consider if you are eligible; they are meant to provide a safety net in times of crisis such as these. They will save you lots of money on health insurance premiums and deductibles, and ensure that you aren’t subject to a mountain of medical debt! Both these programs have year-round open enrollment, so you can apply at any time. 

For short, informative videos on Medicaid, the Affordable Care Act, saving money on prescription drugs, and other topics, visit our Youtube tutorials.

Junk Insurance

A word of caution for those who are tempted to buy insurance policies that are not regulated by the state: don’t do it! There are many “junk insurance” policies out there that do not cover what you think they cover. Plans will often exclude pre-existing conditions, not cover certain basic benefits like prescriptions or mental health services, and often have some kind of “initiation fee” (red flag). I’ve seen plans that only covered hospitalizations on Tuesdays and Wednesdays! Do they tell you this in their marketing emails? No. You have to read the fine print, and most people don’t.

If you’re unsure about a plan, please call us before you enroll so we can help you evaluate it. In the Western Region, call Entertainment Health Insurance Solutions at 833-777-EHIS. In the Eastern Region (including Chicago), call the Artists Health Insurance Resource Center at 917.281.5975. 

Finally, The Families First Coronavirus Response Act makes testing and associated office visits free for all Americans–that is, those with employer-sponsored or Exchange/Marketplace/ACA insurance, Medicare, Medicaid, or no insurance at all. Treatment (beyond testing) is covered according to the terms of your own insurance. Currently, the deductibles and cost-sharing stipulated by your plan apply, although several insurance companies have agreed to waive patients cost-sharing for COVID-19 related treatment. The CARES Act stipulates that the hospital-related treatment costs of those who are uninsured will be covered by the federal government.   

Yours in good health,

Renata Marinaro 

Do you work in performing arts and entertainment and have questions about health insurance? The Actors Fund provides assistance nationally. Contact our regional office closest to you to speak to a counselor.

New York City
917.281.5975

Los Angeles
855.491.3357

Don’t forget to use the resources section of our website. It contains tools to help you make decisions about your health insurance, including new online tutorials on how to choose providers and how to read an Explanation of Benefits. In addition, you’ll find an updated Stage Managers National Health Directory, our national online directory of health care providers recommended by industry professionals that can be used by theaters and touring companies. For these resources and more, visit actorsfund.org/HealthServices. You can also find out more about enrollment assistance and upcoming health insurance seminars near you!