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Wed without Benefits

What to do when you don’t have employer coverage

Not having health care coverage can put stress on a marriage. But options are out there for every couple. Even if one or the other of you lost your benefits, or is self-employed.

To help you find answers, here are some alternatives. As you work through them, remember that you are in this together. That’s the healthiest support anyone could have.

Individual insurance for two

Individual insurance is coverage that you get on your own. No groups, no employers. This could be a great choice for both of you.

Plan types
Plans come in all sizes and prices. Plus, they have tons of options. You can enroll as a family or separately. You can choose a plan that has only preventive or emergencyemergency
A serious medical condition resulting from injury or illness that arises su... more care benefits. Or you could go for total coverage. It depends on the care you need and what you can afford.

Cost and eligibility
To apply for coverage, you usually have to answer questions about your health, age and location. Depending on where you live, the insurer bases your acceptance and rate on your response. This is called medical underwriting.

A 2007 survey found that 89% of people who go through underwriting are eligible.1 So the chances are high you’ll make it in. But there’s always a possibility you might not be eligible. And if you are eligible, the cost could be too expensive.

Is it right for you?
Here are a few questions to help you decide:

• What is the monthly payment?
• What medical services are covered?
• Is preventive carepreventive care
  Programs or services that can help maintain good health (such as annual physical exams or immunizati... more (such as wellness checkups and shots) covered? How about emergencyemergency
  A serious medical condition resulting from injury or illness that arises su... more care?
• Are there benefits for eye care, prescriptions or dentist visits?
• How much of your bills will the plan pay?
• Are the doctors and hospitals you like in the networknetwork
  Also called "provider network." A panel of physicians, hospitals and other health care professionals... more?
• Are there deductibles or limits to what you pay each year?
• Are costs that might drain most of your savings covered?
• Is there a yearly or lifetime limit that the plan will pay?

The bottom line
Individual coverage may be exactly what you are looking for. Just be sure to do your research and ask the right questions.

Almost all insurers have websites. You can read up on plans, get quotes and even apply online. Try eHealthInsurance.com. The site lets you compare plans where you live.

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Out of work and out of coverage

Introducing COBRA
If you recently lost your benefits, COBRA can help. Depending on your situation, it lets you continue your health coverage for up to 36 months.

Eligibility
COBRA coverage is for more than just job loss. It can help workers and their families who are forced to move. It also applies to people who lose benefits because their hours were cut. To be eligible, you had to be enrolled in your employer's health planhealth plan
A health plan that you buy or that is provided by your employer. It pays for health care services. I... more when you worked. The health planhealth plan
A health plan that you buy or that is provided by your employer. It pays for health care services. I... more must also still be available for active employees.

Eligible employees will receive a COBRA notice from their employer. Read this carefully. You must sign up within a specific period. It’s usually 60 days from your eligibility date.

Cost
Sometimes COBRA is the best choice. But that doesn’t make the sticker price any less shocking. The cost can be double or more what was deducted from your pay. 

If you still find COBRA too costly, you may do better with individual coverage. For help weighing your options, visit the U.S. Department of Labor's website for more information.

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Still no luck? Try these tips

Be prepared. Start putting money away for future health care expenses. One idea is to set aside what you would have paid in premiumspremiums
The amount charged by a health insurer for a health insurance policy. If you have a health plan thro... more. It's not the same as insurance. But it gives you some protection against the unexpected. 

Get help cutting through red tape. These days, you shouldn't have trouble finding a health care advocate near you. An advocacy group can help you find insurance, tackle bills and learn more about resources in your state.

Apply for state or federal assistance. If you've exhausted all possibilities, check with your local family and social service offices. They can halp you apply for public health assistance.

Find low-cost care. Many states and cities have health centers and clinics where you can get care for less. The Health Resource and Service Administration has more information. Walk-in and urgent careurgent care
Services received for an unexpected illness or injury that is not life threatening but requires imme... more clinics are popular. They help you get affordable care for everything from the flu to broken bones.

If you have to visit a doctor, dentist or hospital, try and find one that charges you based on your income. Or, if you are already struggling with bills, try to negotiate. Many providers will work with you to set up a billing plan.

Get a health care or prescription drug discount card. For a low monthly fee, many companies sell cards that offer savings on medical, dental, and pharmacy products and services. Every little bit helps.

Go part time. Some retailers offer benefits to part-time workers. 

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No couple wants to be without benefits. But with smart thinking and a little research, you can make it through together.

 

1America's Health Insurance Plans. http://www.ahipresearch.org/pdfs/AHIPGuaranteeAccessPlan.pdf. Accessed July 26, 2011.

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