The Wall Street Journal - 03.04.2020

R4| Friday, April 3, 2020 THE WALL STREET JOURNAL.

The pros and cons of Medicaid,

the ACA and other options

SPECIAL REPORT |NAVIGATING THE CORONAVIRUS

Q & A

EVERYDAY RISKS

I am 70 years old,

live alone and have

no nearby family or

friends. How will I

know the difference

between a severe

cold/flu and Covid-19

before it is too late

to drive myself to

the doctor?

A: If you feel ill,first call your

doctor before going in. If you

don’t have your own doctor,

consider calling a telehealth

provider.

The primary symptoms of

Covid-19 are fever, cough and

shortness of breath. The

CDC has set up a “self

checker” questionnaire that

can help you better under-

stand symptoms you may be

experiencing.

If you are feeling anxiety

around the coronavirus or

about getting sick, call the

federal government’s Disaster

Distress Helpline

(800-985-5990), or text Talk-

WithUs to 66746.

THE MEDICAL EFFECTS

Is the virus

mutating, particu-

larly in a way that

would make it more

contagious?

A: While the virushas made

some genetic changes—as

RNA viruses are prone to

do—none have made it dead-

lier or more contagious, ac-

cording to experts.

If you contracted the

virus and survived,

canyoucatchita

second time?

A: That isn’t yet known.

Sometimes a person is im-

mune to a disease after an in-

fection, but not always. Blood

tests are being developed and

licensed that reveal how many

antibodies are present in peo-

ple who have recovered. These

tests will shed some light on

the prospects for immunity.

A

growing number of Americans are

losing their jobs—and their health insur-

ance—at a time when they are worried

about the need for potentially costly

treatment for coronavirus infection.

There are options for getting health-in-

surance coverage. Here are some:

Medicaid

If you are eligible, Medicaid may be your best bet.

The government program for lower-income and

disabled people expanded under the Affordable

Care Act, and many now qualify. Yet the rules vary

by state.

In 36 states and the District of Columbia, adults

can get Medicaid if their income is 138%, or less, of

the federal poverty level, which is generally $17,609 a

year for an individual.

There is also the Children’s Health Insurance

Program, which can help kids even if their families

make too much for Medicaid.

There are no out-of-pocket charges for enrollees

for most services, and the program covers the

gamut of traditional health-care needs, including

doctor visits, hospital stays and drugs. Not all doc-

tors participate, but hospitals typically do.

You can apply for Medicaid at any time.

To figure out if you are eligible and apply, go to

the federal health insurance marketplace at Health-

Care.gov. Or go to your state’s Medicaid agency di-

rectly. For help finding out the name of your

state’s Medicaid program along with a link to con-

nect to its website, go to http://www.healthcare.gov/med-

icaid-chip.

To find the income cutoffs for coverage for

adults and for children in various states, go to the

website of the Kaiser Family Foundation at

KFF.org, then, at the bottom of the page, choose

State Health Facts, then Medicaid and CHIP, then

Medicaid/CHIP eligibility limits.

What’s the accepted dress code when your office is video chat, as it has suddenly

become for so many people?

If getting dressed up makes you happy, stick to it. “People have to do things that

bring them a bit of joy,” says fashion designer Rachel Comey. “Getting dressed is

part of that—part of keeping our positivity and looking forward.” Ms. Comey recom-

mends knitwear, particularly in calming, neutral colors, or sweatshirts—her brand

has sold more of these recently—as well as sweaters with varying necklines.

“When the time comes, people might start wanting to experiment further,” she

says. “I don’t think we’re there yet, but I feel like there might be interest in explora-

tion and creativity and trying things you never thought you’d try.” —Lane Florsheim

BYANNAWILDEMATHEWS

WhattoDoifYouLose

Your Health Insurance

Affordable Care Act

If you lose your health insurance,

a window opens to get health-insur-

ance coverage immediately under

the federal Affordable Care Act.

You can sign up right away for

ACA coverage, without waiting for

the annual enrollment period in the

fall. You have 60 days after you lose

coverage to do it. You will likely

need to offer documentation proving

that you are losing health insurance.

About a dozen states have also

said that people can sign up for ACA

plans right away even if they didn’t

just lose other health insurance.

Those openings are for a limited

time, so you might want to check

quickly. Go to KFF.org and then

search for “State Data and Policy

Actions to Address Coronavirus.”

In most states, you will use the

federal HealthCare.gov site to enroll

in ACA plans. Other states have

their own online ACA marketplaces.

Go to HealthCare.gov and search for

“The Marketplace in Your State.”

ACA plans often have high premi-

ums, but many people can qualify

for a federal subsidy based on their

income. The subsidy can bring your

monthly cost way down, sometimes

eventozero.

Many ACA plans also have high

deductibles, so you pay a lot of

money before most coverage kicks

in. Some people qualify for federal

help with those out-of-pocket costs

as well.

For everyone with marketplace

plans, coronavirus tests and screen-

ing visits will be covered without

charge to the consumer, under a

new law. Also, a growing number of

insurers are now saying they will

waive out-of-pocket fees on treat-

ment for Covid-19, the illness caused

by the coronavirus.

Cobra

Cobra, which stands for the Con-

solidated Omnibus Budget Reconcili-

ation Act, allows you to keep your

employer health-insurance plan for

as long as 18 months after you leave

your job. You have to sign up within

60 days of losing your job-based cov-

erage. For information about Cobra

from the Labor Department, go to

DOL.gov, choose Topics, then Health

Plans and Benefits, then Continua-

tion of Health Coverage (Cobra).

There are advantages to Cobra,

but also a huge downside: the cost.

Cobra can cost up to 102% of the full

premium on your employer plan.

Most people don’t know how much

that is, because employees generally

only pay a fraction of that total each

month. The average annual family

premium for employer plans last

year was $20,576, and for an indi-

vidual plan it was $7,188, according to a

Kaiser Family Foundation survey.

An upside of Cobra is that you can

keep your current network of doctors

and other health-care providers. This

may be especially valuable if you are in

the middle of treatment for something

and changing would be disruptive.

A family member’s plan

You may be able to jump into a fam-

ily member’s coverage.

If you lose your job and your health

insurance, you should be able to join

your spouse’s employer plan. But you

must do it within 30 days of losing your

own coverage. Call the employer to find

out how. You can also learn about this

option at DOL.gov: Choose Topics, then

Health Plans and Benefits, then Portabil-

ity of Health Coverage.

If you haven’t just lost your own cov-

erage, you may need to wait until the

employer’s annual enrollment period.

If you are under 26, you can be added

to your parents’ plan. Losing your health

insurance should open up a special 30-

day enrollment window for you to do

this. Your parents will have to contact

their employer or insurer.

Short-term plans

Many insurers sell short-term

health-insurance plans, though the

length of time and availability varies by

state. You should approach these op-

tions cautiously, however. Researchers

with the USC-Brookings Schaeffer Ini-

tiative for Health Policy recently found

that some agents and salespeople exag-

gerated the coverage such products

would offer for Covid-19 patients.

Often, you can get these plans only if

you are healthy. Unlike ACA insurance,

they can reject consumers who have

pre-existing conditions. Also, they often

won’t cover care that stems from a pre-

existing condition, including one that

you didn’t know about when you signed

up.

Just as important, their coverage can

be very limited. They don’t have to in-

clude the benefits required of ACA

plans, so they may have huge gaps,

such as lacking maternity and mental-

health coverage.

Some plans, known as “limited in-

demnity” products, will pay only a set

sum toward care such as a hospital

stay, which can leave consumers on the

hook for the difference between that

amount and the full charge.

In the case of a serious Covid-19 ill-

ness, that could be many thousands of

dollars. Using data from 2018, the Kaiser

Family Foundation estimates the total

cost of a hospital admission for pneumo-

nia with major complications was more

than $20,000 on average for people cov-

ered by employer plans. The same analy-

sis found the total median cost of a hos-

pital admission for a respiratory

condition requiring 96 hours or more of

ventilation was $88,114. The charges

could be far more if you are enrolled in

a limited plan, which may not include a

contracted network of hospitals.

Ms. Mathews is a reporter for The Wall

Street Journal in Los Angeles. She can

be reached at [email protected]. FROM TOP: JOHN MINCHILLO/AP PHOTO; MATTHEW HOLLISTER; ICONS: ISTOCK

You can sign up immediately for ACA coverage,

without having to wait for the annual

enrollment period in the fall.

The New Dress Code

Tips for

Video Chat#1