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Health Insurance Options

I've been laid off and lost my health insurance, what do I do? 

Pennsylvanians have health insurance options. Check out your options to see what's best for you and your family.

  • Medical Assistance. Depending on your income, you and your family may qualify for free or low-cost health insurance through Medicaid or the Children's Health Insurance Program (CHIP). Enrollment in these programs is open year-round. Medical Assistance provides comprehensive coverage and is there for people who fall on hard times and need help. Visit www.compass.state.pa.us to see if you qualify.
  • Pennie - PA's State-Based Exchange. If you've recently lost your job-based health coverage, in the past 60 days, you qualify for a special enrollment period (SEP) and can shop for and enroll in a plan at www.pennie.com. You may qualify for financial help to pay for your plan, but only if you don't qualify for Medicaid Assistance. Here is a list of exchange assisters in your area who can help you apply for coverage. You can also search by using the find a health center page.  If you have additional questions or need further assistance, please contact the PACHC's Navigator Hub at 1-866-944-CARE (2273).
  • COBRA Continuation Coverage. COBRA allows you to continue the coverage provided by your former employer. If you are entitled to elect COBRA coverage, you must be given an election period at any time for up to 60 days after the national emergency declaration is lifted for COVID-19. If you choose to continue your COBRA health insurance plan at your own expense, you will also pay the portion of the premium your former employer paid on your behalf. Just because you may be entitled to elect COBRA coverage, this does not mean you must elect it. It is recommended that explore your coverage options before deciding, as sometimes marketplace coverage may be the more affordable option. Learn about your COBRA rights and options from the U.S. Department of Labor by clicking here. You can also view frequently asked questions about COBRA by clicking here. If you work for a small business (2-19 employees), you may be offered Mini-COBRA. You can view frequently asked questions about Mini-COBRA by clicking here.

The rest of this document includes Frequently Asked Questions about Medical Assistance and Marketplace financial assistance and how to determine your income when you apply.

*If you lost your employer coverage, be sure to determine when your employer ended the coverage. If you have medical bills after your coverage ended, the bills may not be paid.

 

CARES Act Payments

Because of the CARES Act I received a payment of $1,200 per adult and $500 per dependent child. Does this impact how much I will pay for my health insurance? 

No. This payment is not included in income for either Medical Assistance or Pennie - PA's State-Based Exchange financial assistance. 

Does the additional $600 per week in unemployment benefits I receive due to the Federal Pandemic Unemployment Compensation (FPUC) in the CARES Act impact how much I pay for health insurance? 

The additional FPUC unemployment compensation is not included as income for Medicaid or CHIP. The additional compensation is included as income for the purposes of determining your eligibility for financial assistance to enroll in coverage through the Marketplace.

Medical Assistance 

If you lose your job and health insurance, you and your family may qualify for Medicaid or CHIP. You can enroll in these programs at any time – you don't need to wait for an open enrollment period. You are eligible for these programs based on your expected monthly income. For example, a typical family of four must have an income of less than $2,904 per month to qualify for Medicaid. A single adult, age 64 or under, must have an income of less than $1,414 per month to qualify for Medicaid. These programs provide coverage and care at little or no cost to you. Once you are enrolled in Medicaid, you are allowed to keep it at least through the end of the COVID emergency. 

You can find out more information on CHIP and the income limits for this program at www.chipcoverspakids.com.

How do I apply for Medical Assistance? 

The best way to apply for Medical Assistance is the Commonwealth's COMPASS tool, available at www.compass.state.pa.us

Does the income I earned before I was laid off count for Medical Assistance programs? 

No. You qualify for Medical Assistance based on your expected monthly income. The income you earned earlier in the year does not affect whether you qualify. 

How do I know how much of my unemployment benefits count as income for Medical Assistance? 

Your regular unemployment benefits are included in income for Medical Assistance, but the additional FPUC benefits are not. The Pennsylvania Department of Labor & Industry sends unemployment benefits and FPUC benefits in separate payments in alternating weeks. When you apply for Medical Assistance, include the amount of the regular benefit but not the FPUC benefit. 

I lost my health insurance when I was laid off and am interested in signing up for a health care plan. How will this impact me? 

Losing job-based insurance qualifies you for a Special Enrollment Period. Visit Pennie - PA's State-Based Exchange to sign-up for health insurance on www.pennie.com