Healthcare in the Time of Covid: Insurance and Healthcare Directives

1

For hosts who have lost their health insurance or don’t already have health insurance:

If you don’t have health insurance or if you have recently lost your health insurance it is 99.99% likely that you qualify for a Special Enrollment Period and can get health insurance either on Healthcare.gov or your state’s healthcare marketplace, if it has its own. Also some states are extending the Special Enrollment Period to all residents without exception right now.

If you have lost health insurance at work and are paying for COBRA coverage, this still includes you because you are likely to get a better deal on the marketplace and possibly even the same insurance plan, so it’s worth checking it out. COBRA is usually the most expensive way to pay for health insurance. And qualifying for COBRA qualifies as a loss of insurance for the special enrollment period. It won’t hurt to have a look at other options.

Depending on your current income (or lack thereof), you may qualify for savings, tax credits or possibley even Medicaid for free. There are plans available that are very local-based, e.g. you need to use providers in your local area or that are part of a local hospital system (Kaiser in Los Angeles as an example). These will cost significantly less than plans with ‘National Provider Directories’ and it’s doubtful you’ll be needing a doctor 6 states away right now so I recommend these local/regional plans as your best bet right now.

If you don’t have health insurance and think you can’t afford it, then you will probably get some for free, so please look. It’s better to have cheap-ass health insurance than no health insurance at all. You do not want to show up at a hospital without an insurance card right now.

(For anyone who hasn’t used a marketplace for their health insurance before, please know that it is just “regular” insurance like BCBS, Humana, Cigna, Kaiser, etc - there is no such thing as “obamacare”, the marketplace is merely regular insurance like you would get at work but you can buy it as an individual.)

:mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask:

For hosts who already purchase health insurance from the Healthcare Market Place:

If you have your health insurance from either Healthcare.gov or your state’s marketplace, get on the website and update your income information asap. If you’ve had a decrease in income you may qualify for cost-sharing or tax credits that you didn’t qualify for previously. If you already have some cost-sharing or tax credit benefits, then you probably qualify for more now.

:mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask:

For hosts that have an HSA (Health Savings Account) or an MSA (Medical Savings Account):

If you have qualified for Unemployment benefits or are now paying for COBRA continuation insurance, you can now use funds from an HSA or MSA to pay your health insurance premiums as they will be considered a “qualified medical expense” (tax-free and penalty-free withdrawl) for the time period you are receiving unemployment benefits or paying for COBRA benefits. (COBRA is when you start paying for your health insurance from work after your employer no longer pays it, e.g. after losing a job).

Note: This is completely straight-forward for all HSAs and Archer MSAs. However, I am not sure about MedicareAdvantage MSAs and it’s unclear in the IRS docs so it would be best to contact your account or the IRS or your MSA servicer to see if your Part B or Part D or supplemental premiums might qualify. If anyone has this particular situation, I’d be happy to research and find out for you if you let me know.


:mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask:

For hosts who need to use their healthcare benefits right now:

Please consider using the Tele-Health benefits that nearly every insurance company and Medicare are providing right now. You can find information for them on your insurance’s website. A hospital, clinic or doctor’s office is the worst place to expose yourself to right now. Most states have made special provisions so that you can get what you need from Tele-Health services, including prescriptions, etc.

Please know that most states have made special rules for healthcare services and providers right now, as has Medicare. One example is prescriptions. If you have a prescription that you had strict timelines on (e.g. can only fill every 14 days or something), many of those restrictions have been suspended and you can refill sooner. Another example is what your insurance requires you to pay towards your deductible, there are exceptions right now. Healthcare can be difficult to navigate and there are a lot rules and provisions that add to that but many of them have exceptions or are suspended for right now. Your state’s dept of health and/or governor’s office should have details.
:mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask::mask:

Also, perhaps your spouse/kids/friends/neighbors could benefit from this information. Health insurance premiums are one of the largest parts of people’s budgets and it’s also a bad time to lose or go without health insurance so please spread the word(s) - hygenically of course :wink:

5 Likes
2

@JJD,

Your post is probably one of the most important to be made regarding Covid & health insurance in the US. I’m sure many of you compatriots will be very thankful for such clear and informative information and will thank you profusely, even if silently.

It is an issue we think little of in the UK. In many ways we are so complacent about our beloved NHS, but not right now.

I remembered some American guests who some years ago who spoke of our “socialised” medicine. My response was that Brits don’t understand it that way; that we just simply see it as a universal benefit.

It was like watching scales fall from their eyes.

2 Likes
3

Healthcare Directives and Healthcare Proxies

It’s also a great time to get your Healthcare Directives together. I believe it’s imperative that everyone have them. Here’s a link as an over-view of information and I’m so glad that it’s on the National Institute of Aging page because it’s a nice segue into my next point :wink:

Everyone should have healthcare directives and a healthcare proxy regardless of age.
(And also regardless of marital status for that matter).

If you are someone who doesn’t want extreme-measures then it’s even more important that you have them before you are elderly. Because the system will usually have some mercy on an elderly person, but if you’re 30, they’re going to extreme measures no matter what. If that’s not what you want, you need to have it documented.

Coma wards are filled mostly with young people on multiple machines, including ventilators and feeding tubes. Some of them have been there for 20 years and are only 40. If that scares you, you should have healthcare directives filled out. OTOH, if that is your wishes for yourself and maybe even found it a little offensive that I mentioned it, then you also need to have healthcare directives so that those wishes are clear. Regardless of your wishes it’s important to have them documented. If you don’t have healthcare directives then you may not get what you want - no matter what you want.

Do it for the people who care about you. If you don’t have directives, they will have to guess and may not be able to have any say at all in any matter. It will be stressful and frustrating for those who care about you. Part of the directives will be assigning someone to make healthcare decisions for you if you are not able to - a healthcare proxy. It is always better to have someone representing you that cares about you and knows you than to merely leave it up to the system/state. Even if your wish is to be kept on machines for 20 years, trust me, you do not want to do it as a ward of the state so you still need a healthcare proxy.

Here’s a general overview:

These documents vary by state in the US so it’s important to have the right form. AARP has a link to the forms for each state here:

And like everything else, covid complicates this. These forms usually have to be signed by witnesses and/or notarized. Neither of those things are simple right now.

This link has a decent overview of options for this issue, including remote notarization:

https://www.nolo.com/legal-encyclopedia/notarizing-and-witnessing-legal-documents-during-the-coronavirus-crisis.html
There is a link to a map of states that accept remote notarization services. Remote notarization was already legal in some states and many other states have made it legal temporarily during the covid crisis.

2 Likes
4

Do you mind if I copy and paste this on FB, changing the references to “hosts”?

1 Like
5

Not at all, but thanks for asking. I’d love for the information to get to as many people as possible!
Thank you for sharing it :slight_smile:

1 Like
6

You should probably adjust the thread title so people don’t miss this excellent information.

1 Like
7

Wah? And lose my literary reference? :wink:

Do you mean the advance directive stuff?

I’m totally open to suggestions or you just changing to what you think works best with your moderator-powers if you’d like.

8

LOL. I see you changed it.

I just think people might skip healthcare but be interested in advanced directives. Not everyone reads 99.9% of posts like I do.

1 Like
9

For sure. It is likely not relevant for some.

However, anyone with an HSA should at least take notice of the opportunity to pay their premiums from there right now. Alternately, if they don’t want to take money out of there right now, they could do it later if they get strapped for cash at a later date - e.g. if you qualify to use the money from the HSA for insurance premiums for the next few months and they cost you $1600 for those months, you could take out the $1600 later, even in two years or whatever legitimately. There are quite a lot of safety nets now but I doubt they will last.

1 Like
10

Certainly. I mentioned a few weeks ago that people with paychecks should look into reducing their withholding (W-4) I expect my taxable income to be significantly less even if Congress doesn’t pass any sort of tax relief later this year.

1 Like
11

I took advantage of that today with Medicare paying. Had an online video doc appointment to talk about test results (hey my A1C is down to 5.9, and should go lower as I exercise more), my recovery from several surgeries this winter, and whether I should be hosting hospital workers given my history of asthma & tuberculosis.

She confirmed my reasoning that I probably shouldn’t host again until a vaccine has been widely available for a while, and definitely not hospital temps, because my space and the Air space share a front porch and vestibule.

4 Likes