Losing job-related coverage

You can lose job-related coverage for a number of reasons, such as:

• If you’re laid off or quit

• If your hours are reduced

• If your employer no longer offers health coverage

• If your employer stopped offering health coverage and switched to an Individual Coverage Health Reimbursement Account (ICHRA)

• If you’re a dependent and the subscriber for your plan qualifies for Medicare

• If you’re a dependent and the subscriber for your plan dies

• If you’re a dependent and you get legally separated or divorced

• If you turn 26 and no longer qualify as a dependent on a parent’s employer-sponsored plan

Whether you’re losing your job, your employer no longer offers coverage, or you’re no longer eligible for job-related coverage on another subscriber’s plan, there are several ways to stay covered, including:

• An individual plan through Kaiser Permanente for Individuals and Families (KPIF) — which you can buy directly through Kaiser Permanente or your state’s Health Benefit Exchange

• Medicaid (Kaiser Permanente may not offer a Medicaid plan in all Kaiser Permanente regions)* and other federal and state health coverage programs

• COBRA (continuation of employer-sponsored coverage)

• Coverage through a new employer, or as a dependent on a spouse or partner’s plan

*If you qualify for Medicaid in your state, you may be eligible to receive your Medicaid health care with Kaiser Permanente.

COBRA continuation coverage may be available to you to continue employer-sponsored coverage for a limited time.

• COBRA continuation coverage is generally only available through employers with 20 or more employees.

• COBRA continuation coverage usually lasts for 18 months if you lose job-based coverage.

• You pay the full plan membership bill every month, plus a small administrative fee, so it can be a costly option.

To learn about any COBRA continuation coverage options available from Kaiser Permanente you may have, contact your employer.

• If you buy a Kaiser Permanente Individual or Family plan through Kaiser Permanente or the Health Benefit Exchange, coverage can start the first day of the month after you lose your coverage, depending on when you apply.

• If you elect COBRA continuation coverage, your employer-sponsored coverage will continue without a break in that coverage.

• If you apply for Medicaid and are eligible for coverage, coverage may start either on the date you apply for Medicaid or the first day of the month you apply, depending on your state’s Medicaid rules.

Depending on your family size and income level, you may be able to get help in a number of ways. You may qualify for:

• Federal financial assistance to help pay your monthly membership bill, or reduced out-of-pocket costs for care

• Coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or other government-funded programs

• Financial assistance through Kaiser Permanente’s Medical Financial Assistance and Charitable Health Coverage programs (not available in all Kaiser Permanente regions)

To find out if you qualify:

• Check healthcare.gov or your state’s Health Benefit Exchange to see if you qualify for Medicaid, CHIP, or other government-funded programs.

• To learn about Kaiser Permanente’s Medical Financial Assistance and Charitable Health Coverage programs, visit kp.org/mfa and kp.org/chc.

Depending on your circumstances, the deadline to enroll varies. If you have a major life event — known as a qualifying life event — like losing coverage because you lost your job, getting married or divorced, or having a baby, you can apply for coverage for a limited time outside the yearly open enrollment period. This is called a special enrollment period.

• If you’re applying for an individual plan, you have a special enrollment period that typically lasts 60 days from the date of your life event, but in some cases extends from 60 days before to 60 days after the event.

• If you’re applying for employer-based coverage, you also have a special enrollment period, but in this case it lasts at least 30 days from the date of your life event — duration varies by employer.

• If you opt for COBRA continuation coverage, you can sign up within 60 days of the date you lose coverage or the date you get your COBRA election notice — whichever is later. For state COBRA continuation coverage, sign up by the date specified in your COBRA election notice. Check your election notice to confirm your deadline.

• If you qualify for Medicaid, you can apply anytime — with no time restrictions.

You’ll want to act quickly: If you don’t apply by your deadline, you’ll usually need to wait until the following year’s open enrollment period to apply for new coverage.