Q & A: May 2016

Q & A: May 2016

What Do We Do Now? My Husband Lost His Job And Our Healthcare Coverage

Q: My husband recently lost his job in a company re-organization. I was getting my healthcare benefits through his employer. He is 64 and I’m 67. I’m still working, but coverage through my employer is much higher than we paid previously. Can you explain our options at this point? Neither one of us has started Social Security.

A: If your husband’s company had 20 or more employees, and your husband’s former employer still has the same health coverage, you and your husband may have the option to temporarily continue to get healthcare coverage under your husband’s former employer plan as provided by the Consolidated Omnibus Budget Reconciliation Act (COBRA). That coverage now, however, is likely to be more expensive than it was while your husband was an active employee, and it’s only a short-term option. These are two reasons why both you and your spouse should explore other options promptly.

The loss of a job entitles each of you to a Special Enrollment Period (SEP), but the rules and deadlines will differ for each of you. Because your husband is under the age of 65, he should check options for coverage on the Health Insurance Marketplace (www.Healthcare.Gov). Because of your husband’s job loss, your income may be lower and he may qualify for an advance premium tax credit subsidy that would lower the cost of premiums.

To qualify for special enrollment in a Marketplace plan, your husband will need to select a plan within 60 days after losing his job-based coverage. If you need coverage in the time between losing job-based coverage and beginning coverage through a Marketplace plan, your husband may want to continue COBRA coverage from his former employer’s plan. He should learn more about his special enrollment period, and coverage at www.HealthCare.gov or by calling 1-800-318-2596.

Because you are over 65, you are subject to Medicare’s Special Enrollment Period rules that apply to the loss of health insurance coverage through you or your spouse’s former employer. You need to enroll in Medicare Part B during the 8-month period that begins the month after your husband’s employment ends or the employer health coverage ends, whichever happens first. Coverage under COBRA, however, would NOT be more than a temporary option for you because you would NOT be eligible for a Special Enrollment Period when that coverage ends, so don’t wait to enroll in Medicare. You have 8 months to sign up for Part B and Part D without penalty, starting after the loss of your husband’s job.

In 2016 your Part B premium would be $121.80 per month if your family income is under $170,000. (If income is higher beneficiaries pay higher Medicare Part B and Part D premiums.) In addition you will need to decide whether to purchase a Medigap supplement and enroll in a Part D plan for drug coverage, or to enroll in a Medicare Advantage plan that includes Part D coverage.

To learn more about your Enrollment Periods check your 2016 Medicare & You handbook, call 1-800—MEDICARE (1-800-633-4227) or visit www.Medicare.gov. You can get free unbiased one-on-one counseling to help you sign up for Medicare and select the best way to receive coverage through your State Health Insurance Assistance Program (SHIP). Many of the programs operate through local senior centers or area agencies on aging.