Health insurance

A person who loses a job has options to keep health insurance, but they can be costly.

But letting insurance lapse can be even more costly, said Judy Jacobs, outreach coordinator for the WindRose Health Network, which runs three local health clinics.

People need to consider what they would do if they had no insurance and were injured in a car accident, their child broke a bone or they needed emergency care, she said.

Those bills can quickly add up.

"It's serious to be without medical insurance," Jacobs said.

But families need to weigh their options, including what they can afford, she said.

First, experts recommend checking if a spouse's policy can cover you and your family. Some companies will let an employee add a spouse or family member during a time of crisis, such as a job loss, not just during an annual enrollment period, Jacobs said.

If that is not possible, other options include:

  • The state offers health insurance coverage to children, pregnant women and low-income families with a range of options, including low-cost plans and premium-free plans.

The programs are based on income levels.

For example, state guidelines say a family of four would be eligible for their children to have coverage if their income level was $4,417 or less per month. That policy would include a monthly premium, which typically ranges from $33 to $70 per month, Jacobs said.

For a premium-free plan to cover the children, a family of four would need to have an income of $2,650 or less per month, according to state guidelines.

Adults between the ages of 19 and 64 who are not eligible for health insurance through their employer or who are unemployed can qualify for insurance, but they must be without an insurance plan for six months.

Eligibility for the plan and premiums also are based on income guidelines. A family of four would generally need to have an income of less than $44,100 per year to qualify.

Jacobs assists families in applying for the benefits, getting the needed documentation and making sure the application is complete and submitted to the correct office. For help, call Jacobs at 474-0148.

You can also call the Indiana Family and Social Services Administration at (877) 438-4479.

To download an application for insurance, visit www.in.gov/fssa/ompp/3006.htm</a> or pick up a form at a local enrollment center in the county, including the Pleasant Township Trustee Office at 60 N. Railroad St. in Whiteland or the Human Services Inc. office at 98 W. Madison St. in Franklin. For a list of other offices, visit www.in.gov/fssa/ompp/3030.htm.

  • A federal program, called COBRA, extends insurance benefits for people who were recently laid off or terminated or had hours reduced and lost insurance benefits. The program extends benefits for up to 18 months under their former employer's plan, but the person must pay the total premium themselves.

That means that any cost that was covered by the company, which typically picks up at least half of the monthly premium, will be paid by the former employee, Jacobs said.

To get an idea of what you might pay, you would need to at least double your current monthly premium, Jacobs said. But what companies pay per employee varies widely, she said.

To find out more, call the Employee Benefits Security Administration at (866) 444-3272. A representative can help you find a local office where you can meet with someone to ask questions.

  • Another option is private health insurance through an individual plan.

Multiple companies offer health insurance to unemployed or self-employed families. The cost varies depending on family size, medical needs, deductibles and coverage.

A family of four could pay anywhere from $167 to $300 or more per month, according to an estimate from ehealthinsurance.com.
One recommendation is to check if any professional organizations or other groups you belong to offer group health insurance, which can have lower monthly payments.

  • Local health clinics also offer medical services to uninsured people on a sliding cost scale, based on income, Jacobs said.

The clinics offer the same services as most doctor's offices, including pregnancy care, pediatricians, care for illnesses such as a cold or chronic disease management. The clinics do not offer emergency care that would be offered in a hospital emergency department, she said.

People must make appointments to be seen at the clinics, she said.

Here's what's available:

  • WindRose Health Network serves people in need for a reduced cost based on the patient's income and insurance coverage. A scale determines how much they pay for medication and doctor's visits. Locations: 911 E. Main Cross St., Edinburgh, (812) 526-9999; 14 Trafalgar Square, Trafalgar, 878-2301; 543 Washington St., Hope; 8404 Siear Terrace, Suite 208, Indianapolis, 534-4660.
  • The St. Thomas Clinic, founded in 1996 as an outreach of St. Thomas Episcopal Church in Whiteland, uses donations and grants to fund its operations. Location: 600 Paul Hand Blvd., Franklin, 535-6057.

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