My daughter lost her job. Is she eligible for the marketplace insurance?

A reader asks if her daughter can buy insurance on the federal exchange after losing a job.

QUESTION: Our daughter lost her job and had insurance until May 31, 2014. She has been unable to find another job. She is now in the hospital and may be there for a while. Can she be eligible for the marketplace insurance? Would it pick up her medical bills after June 1st?


ANSWER: Job loss is a qualifying life event that would allow your daughter to purchase insurance on a marketplace exchange within 30 days of losing health benefits. She does not have to wait for the next open enrollment period in November.

The insurance company can set the date when coverage begins, although it must be at least one day after the first premium payment is received and processed. However, coverage may not be retroactive. If your daughter’s income is low enough, she may also qualify for Medicaid. That coverage can be retroactively applied for up to 60 days prior to enrollment. If she is eligible, she can enroll in Medicaid at any time.

Your daughter may also consider staying on her former employer’s plan through COBRA, which would permit her to continue coverage for up to 18 months. However, she would be responsible for the full cost of the premiums, including the share her employer had been paying. Unfortunately, COBRA plans do not qualify for the subsidies that are available on the exchanges to help with the cost of premiums. If she chooses to use COBRA, she can apply for an exchange plan to replace it during the next open enrollment period or when the COBRA coverage expires.

Robert I. Field, Ph.D., J.D., M.P.H. is a professor of law at the Drexel University School of Law and professor of health management and policy at the School of Public Health at Drexel University. Rob and the expert panel of The Field Clinic blog are available to respond to your questions on health care.

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