Health Insurance Enrollment in your Spouse's Group Plan
You may be one of the fortunate ones whose spouse is still working and has health insurance benefits available through that remaining employer. Your circumstances may allow special enrollment in that health insurance plan regardless of enrollment periods. Generally, in order to qualify, you must request enrollment with 30 days of losing your health insurance coverage. After special enrollment is requested, coverage is required to be made effective no later than the first day of the first month following your request for enrollment. This type of coverage is usually the most cost-effective of all the options.



Continuation of Health Insurance Coverage through COBRA
If your former employer does not go out of business and they have 20 or more employees, continuation of your health insurance coverage may be available through COBRA. You should get a notice regarding COBRA and have 60 days to enroll and then it is retroactive back to the day you lost health insurance coverage initially. COBRA coverage is generally available for a period of 18 months. Two caveats regarding COBRA. The COBRA health insurance premiums reflect what your former employer was paying for your health insurance coverage before the job loss. After you lose your job, your health insurance premiums will be 100% of the amount and your former employer will not be paying a portion of the insurance premium. The monthly health insurance premiums may be quite high but this may be the lesser cost option compared to an individual health insurance policy such as what a self employed individual might expect. The second issue is eligibility. Enrolling in COBRA may preclude you from joining another group plan as discussed above until the COBRA benefits are exhausted in 18 months. Other health insurance options should be explored promptly after a job loss and COBRA should be the last option considered in most cases.


Health Insurance Provided by Government Programs.
Medicaid insurance may be available for low income individuals or special needs individuals. Your state may have special programs for children's health insurance for low income households. Medicare is available if you are 65 and over and for certain individuals with disabilities.

Individual Private Health Insurance
The last option for an individual to consider is private individual health insurance coverage. Individuals may qualify for guaranteed access to such coverage, without any pre-existing condition exclusions, if:

They had health insurance coverage of some type for at least 18 months without a significant break in coverage (generally a break in coverage of 63 days or more) and the most recent period of coverage was under a group health plan;

Group coverage was not terminated because of fraud or failure to pay premiums;

They either were not eligible for COBRA continuation coverage (or similar State program), or if eligible for COBRA coverage (or similar State program), they both elected and exhausted COBRA coverage.

Even if they do not meet these criteria they may still be able to obtain coverage. The cost of individual coverage is often higher than similar coverage under a group health plan obtained through special enrollment in another group plan or COBRA.

Self employed people have been obtaining individual and family health insurance on their own for decades so it is not an insurmountable task. Self employed individuals or small businesses with individual health insurance policies typically do not have health insurance plans that are loaded with options like prescription plans, doctor visit co-pay or eyeglass prescription plans. They also may elect a much higher deductible on their health insurance plan. The goal for the self employed person or small business owner is to obtain catastrophic health insurance coverage with an accompanying affordable premium. Bells and whistles greatly add the the monthly health insurance premium. A good option for those self employed or owning a small business is a health savings account.

If you have pre-existing medical conditions, the health insurance underwriter may decide to exclude those conditions for eligibility under your new individual health insurance policy. Please read all policy documents to determine if they include any exclusions.

Your application for individual health insurance may be denied if pre-existing conditions are severe enough threat the health underwriter feels you are a poor risk for individual health insurance through their company. If you are denied health insurance coverage for this reason check with your state agencies. Most states have a High Risk Pool available. The High Risk Pool accepts individuals who can prove denied coverage and they will accept you and cover pre-existing conditions. Be advised that the health insurance premiums through a state risk pool can be quite high.

The good news for those self employed or small business people is that health insurance premiums are tax deductible and certain out of pocket medical expenses may be tax deductible as well.