Each week, I try to cross one difficult task off my to-do list. Last week, I filed my taxes. This week, it was navigating my health insurance options once my COBRA ends next month. To say I was paralyzed by fear to even start digging into this project would be an understatement.
If you’re not familiar with the term COBRA, I salute you. That likely means you’ve never needed to activate the pricey option that allows you to retain your healthcare coverage after leaving employment. You also might not know that COBRA stands for Consolidated Omnibus Budget Reconciliation Act of 1985 which was passed by President Ronald Reagan. While it’s great to have the option to continue your coverage, especially if you’re coverage was comprehensive, COBRA is incredibly costly and requires you to cover the entire plan (sans employer contribution), as well as a monthly administrative fee. But there are positives to COBRA. For up to 18 months (and, depending on your state and your health plan, it could be extended up to 36 months), you get to retain your coverage and stay in a large group, which usually keeps rates down. However, once your time on COBRA is up, don’t expect much help or many options as you transition to a new plan.
For the past few months, I’ve been counting down the days until my COBRA plan ends. I’ve talked to other entrepreneurs, asked my medical providers, reached out to insurance brokers, and even waded into the healthcare marketplace to see what options were out there. I knew better than to get my hopes up too high, but with each conversation, I fell deeper into despair. I spoke with people who had gotten insurance on the marketplace and were paying well more than I was on COBRA, only to have shoddy coverage that their providers wouldn’t accept anyway. The more people I talked to, the more I realized that the only two options appeared to be to take a marketplace plan that was expensive and offered sub-par coverage through an HMO or worse, take a Medicaid plan if you qualify with your income and leave it to chance which providers you can see. As a cancer survivor, neither of these sounded like good options or even options at all to me.
As the days dwindled, I realized I should schedule a dentist appointment before my COBRA dental coverage also ends next month. It was then I realized my dentist’s office would likely have a decent health insurance broker I could speak to. They are a small office with a staff of two people, and I have been seeing them for years. On the call to schedule my appointment, I inquired, and sure enough, within minutes, my phone dinged with the contact for the broker they use. I was so happy I could have cried. The next day, I reached out to the broker they referred me to. She sounded like the right person for this task; knowledgable, a bit pushy, and just as irritated with the system as I was. The more I talked with her and told her about my situation, the more she empathized and assured me I wasn’t alone. In a matter of minutes, she presented me with a couple of options, one more expensive than the next, naturally, and asked me to send over a list of providers I regularly see so she could make sure they were in the plans she was recommending. While I’m still unsure as to what kind of health plan I will have next month, talking to the broker made me feel a lot better and more informed.
One thing I learned from talking to almost everyone I could think of about my health insurance quandary, is that a lot of people are unaware of what the health insurance situation is really like in this country. If you have an employer, this is probably something you never gave much thought to. But when you don’t, it can be an incredibly stressful situation to navigate on your own. If you’re an entrepreneur in the same or a similar boat, I would recommend finding a broker who can help you with some of these challenges. I spent a lot of time on the marketplace website, as well as calling my provider, United Healthcare and COBRA, for assistance, and the information I received was limited at best. The marketplace can get confusing quickly, often making things appear better than they are, which is where working with a skilled broker can be beneficial.
I will be so happy once I am on my new insurance plan, and I can put this research project to rest. But in the meantime, please wish me luck.
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