Health Insurance HQ: An Update on the Health Care Landscape | Entertainment Community Fund

Health Insurance HQ: An Update on the Health Care Landscape

Welcome to Health Insurance HQ—coming to you from the experts at the Entertainment Community Fund's Artists Health Insurance Resource Center and special guests!

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What the End of the Covid-19 Emergency Means for Your Health Insurance

Dear friends,

As of May 11, 2023, the Covid-19 Public Health Emergency (PHE) has come to an end. This is an FAQ on how this might affect your health insurance.

The Entertainment Community Fund also offers personalized health insurance counseling via the Artists Health Insurance Resource Center (Eastern and Central Regions) and Entertainment Health Insurance Solutions (Western Region).

What’s going to happen when the Public Health Emergency (PHE) ends?

During the pandemic, the government instituted a number of rules and regulations regarding health care. The end of the PHE will unwind these rules. In many cases, things will go back to the way they were pre-pandemic.

What if I’m on Medicaid, Medi-Cal, the Essential Plan or Child Health Plus?

It’s important to note that no one is being thrown off Medicaid (or any other program) when the PHE ends. The rule changes will be phased in over the next 12 months. As your insurance ends, you will have to proactively renew your coverage.

You should pay attention to any notices you get from your state Marketplace. You will need to update your account and renew your coverage when your insurance ends—just like before the pandemic. You can always contact one of our health insurance counselors if you need help.

In New York, starting in June 2023, as your Medicaid, Essential Plan or Child Health Plus plan approaches its end date, you will have to update your NYS of Health account with new income information. Depending on your updated information, you may remain on the same program or you may have to switch to another coverage.

What if I have a Bronze, Silver, Gold or Platinum plan; or I have health insurance through my union or my job?

In general, the end of the emergency provisions will not alter your coverage. The biggest change will be to the way Covid testing, treatments and vaccinations are covered. See the chart below.

Your Plan Renewals COVID-19 Telehealth
Medicaid, Essential Plan, CHP Renew at the end of your 12 months of coverage with new income info. Testing, treatment and vaccines covered without cost. Yes
ACA plans (e.g., Bronze, Silver, Gold, Platinum) Renew during open enrollment (November-January). Testing and treatment will be subject to cost-sharing. Vaccines will continue to be free. Yes—but depends on your plan provisions. If telehealth was covered before, it will continue to be covered.
Union/Employer When you requalify for union coverage, or during your employer’s open enrollment period. Testing and treatment will be subject to cost-sharing. Vaccines will continue to be free from in-network providers. Yes—but depends on your plan provisions. If telehealth was covered before, it will continue to be covered.
Medicare No changes. Vaccines: Free
Testing: Free when ordered by a physician. Over-the-counter and at-home tests will no longer be free.
Treatment: No change. Cost-sharing will apply.
Current telehealth rules will remain in place until at least December 31, 2024.

 

What if I have Medicare?

In general, there will be very few changes to the way Medicare operates. The big change will be that over-the-counter and/or at-home Covid tests will no longer be free. PCR or rapid tests ordered by a physician will continue to be without cost. See the chart above.

Does any of this affect COBRA?

COBRA rules are going back to the way they were before the pandemic. That is, you will now have 60 days to opt-in to your COBRA coverage once your union or employer coverage ends.

Can I still enroll in health insurance on the Marketplace outside of Open Enrollment?

No. Only if you have what’s called a qualifying life event. Qualifying life events include getting married, having a baby, losing insurance coverage, moving, etc. View a list of qualifying events here.

Learn more about when Open Enrollment takes place in your state.

In New York, enrollment will remain open through at least the beginning of 2024. This means that New York residents can apply for or change their coverage at any time, even without a qualifying life event.

Where Can I Get More Information?

To learn more, visit the Centers for Medicare & Medicaid Services or KFF.

Yours in good health,


Jim Bracchitta

Do you work in performing arts and entertainment and have questions about health insurance? The Entertainment Community Fund provides assistance nationally. Please contact the regional office closest to you to connect with a counselor.

New York City
Visit entertainmentcommunity.org/ahirc

Los Angeles
Visit ehisca.com