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Cómo apuntarse
Talk to the employer’s Human Resources department to learn the rules for signing up. An employee may have to be working for a certain period of time, called a waiting period, before signing up for health coverage. The waiting period cannot be longer than 90 days.
It’s important to sign up for coverage when it is first offered, otherwise you may have to wait until the annual open enrollment period, which is usually near the end of the year. Certain changes in family or coverage status may trigger a special enrollment period. For example, if you get coverage through your employer and get married or have a child, your new spouse or baby will be allowed to sign up with your employer-sponsored coverage.
Keeping Your Coverage When You Aren’t Working Temporarily
The Family and Medical Leave Act (FMLA) allows employees to take unpaid leave for certain family and medical reasons, such as the birth of a child or to care for a sick family member. FMLA gives employees that meet certain conditions up to 12 weeks of unpaid leave each year and also protects group health benefits during that leave. Employers must continue to provide coverage for an employee on FMLA leave that is the same coverage at the same cost that the employee would get if the employee were working. Read more about the FMLA in DB101's Know Your Rights and Responsibilities article.
The Uniformed Services Employment and Reemployment Rights Act (USERRA) protects the employment and health care coverage of people who serve in the uniformed services. It allows for health benefits to continue for up to 24 months when a person is not working because they are serving in the uniformed services. The U.S. Department of Labor Veterans’ Employment and Training Service (VETS) has more USERRA information.
Options When You Lose Eligibility for Your Employer-Sponsored Coverage
If an employer or former employer no longer gives you health care coverage because you, your parent, or your spouse was laid off, quit, or had hours reduced, there are different coverage options for you. Look into all of them and see which makes the most sense for your situation.
Other Employer-Sponsored Coverage
If you lose your employer-sponsored coverage, but have a spouse who could get coverage for you through their job, or if you are under 26 and you have a parent who could get employer-sponsored coverage for you, look into those. If you are in that situation, your loss of your health coverage creates a special enrollment period that would allow you to sign up for those plans, even if it is not regular open enrollment time.
Note: If you are in this situation, you will not qualify for government help to pay for an individual plan on Covered California.
Public or Individual Coverage Through Covered California
Your most affordable options may be on Covered California. That’s because if you lose your job, your family income probably goes down significantly and you may qualify for programs or help that you previously didn’t qualify for. Depending on your situation, you may now qualify for Medi-Cal or government help paying for an individual plan through tax credits. Check out DB101’s other health coverage articles to learn more about these options.
COBRA, Cal-COBRA, and OBRA
COBRA is a federal law that covers employees of businesses with 20 or more employees. It allows employees and family members to keep getting the same health plan they got through the employer for up to 18 months after losing employer-sponsored coverage because of a qualifying event (most reasons you might lose coverage qualify). The time periods are sometimes different for spouses and dependents.
California has another law called Cal-COBRA that is similar to COBRA but covers more people, including people who work for employers that have 2-19 employees. It also lets people who worked at any employer with 2 or more employees to keep getting the same health plan they got through the employer for up to 36 months after the qualifying event, twice as long as standard COBRA.
You will have to pay the entire premium for COBRA or Cal-COBRA, including any amount that your employer paid in the past. Your plan could be a lot more expensive than you realize.
OBRA extends COBRA for up to 11 additional months for people with disabilities. The premium can go even higher (up to 150% of the premium for current employees with the same plan), so this should only be done if you have no other options.
For detailed information, see the U.S. Department of Labor's COBRA website and the California Department of Managed Health Care's FAQ about COBRA and Cal-COBRA.
COBRA can turn out to be very expensive. It used to be really important because it was so hard for individuals, especially people with disabilities, to get an individual insurance plan. Now, Covered California makes that much easier and often much cheaper.
However, there are still some situations when COBRA or Cal-COBRA makes sense. Here are a couple of examples:
- If your employer-provided coverage had a high deductible and you have already paid the deductible for the year, think about staying on that plan until the end of the year. If you get a plan on Covered California with a deductible, you will have to start over on paying the deductible.
- If you have a plan and you have already paid the full out-of-pocket maximum for the year, it also might make sense to stay on it until the end of the year, because the only thing you'll have to pay to get health care is your monthly premium; you won't have to spend on copayments, co-insurance, or anything else.
Think about your situation. If you decide to get continuation coverage, remember that it may make sense to stop your continuation coverage and switch to an individual plan through Covered California at the end of the year, especially if you qualify for government subsidies for a plan. See DB101's Buying Coverage on Covered California article for more information.
También
Cobertura médica privada en CoveredCA
You can get private health coverage on CoveredCA. The government may help you pay for it.
Medi-Cal
Medi-Cal es una cobertura para personas de bajo ingresos con y sin discapacidad.
Medicare
Medicare es cobertura de salud pública para personas con discapacidad y personas de edad avanzada.
Ayuda experta
SSI y SSDI
1-800-772-1213
SSI, SSDI, y el trabajo:
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Llame a Disability Rights California
1-800-776-5746 -
Llame al Programa del Boleto para Trabajar
1-866-968-7842 - Contacte a un/a consultor/a de incentivos de trabajo (WIPA)
Medi-Cal
- Contacte a su agencia de servicios sociales del condado
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Llame a Disability Rights California
1-800-776-5746 -
Llame a la Health Consumer Alliance
1-888-804-3536
IHSS
Medicare
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Llame a Medicare
1-800-633-4227 -
Llame al Programa de Asesoramiento y Defensa sobre Seguros Médicos (HICAP)
1-800-434-0222
California SDI
Preparación para trabajar
- Contacte a su oficina del Departamento de Rehabilitación (DOR)
- Contacte a su centro de trabajo AJCC (One-Stop)
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