PA UC benefits and losing health insurance - desperate for advice
Just got laid off yesterday and I'm freakin out about my health insurance. My employer told me coverage ends May 31st (just a few weeks away) and I have NO IDEA what to do next. Filed my initial UC claim last night but now I'm worried sick about insurance. Called Medicaid office this morning and the person said my final paycheck might put me over their income limit? How does that even make sense when I'll have zero income after that? Does anyone know if PA unemployment offers any help with health insurance or what my options are? I take medication daily that costs a fortune without insurance, and I can't afford COBRA on unemployment benefits. Need advice ASAP!!
18 comments
CosmicCrusader
You need to look into the Marketplace plans through healthcare.gov. When you lose your job-based coverage, you qualify for a Special Enrollment Period, so you can get a plan outside the normal enrollment window. Your income will be lower now, so you might qualify for a subsidy that makes it affordable. I lost my job in January and got a decent plan for about $175/month with a tax credit. Applying for UC benefits won't affect your healthcare options - they're completely separate systems. Good luck!
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Aisha Rahman
•Thank you so much! I didn't know about the Special Enrollment thing. But will they count my final paycheck when calculating subsidies? That's what's confusing me. The Medicaid person made it sound like I'd be rejected because of that one last check, but then I'll have nothing coming in except UC benefits.
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Ethan Brown
heyy don't panic. lost my job in march and went thru the same thing. the medicaid ppl always say stuff like that on the phone but apply anyway! they look at MONTHLY income and ur situation changes month to month. first month might be over if u got severance but after that UC is usually low enough to qualify. worse they can say is no right?
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Aisha Rahman
•That makes me feel a bit better. No severance unfortunately - just my final paycheck with unused PTO. I'll apply for Medicaid anyway and see what happens. Thanks for the encouragement!
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Yuki Yamamoto
I know you're focused on health insurance (rightfully so), but make sure you're doing your weekly certifications for UC benefits correctly. You need to complete at least 2 work search activities each week and report them or you could lose benefits. Also, did you get your PIN in the mail yet? Sometimes it takes a while, and you'll need that to file your weekly claims. As for insurance, Pennsylvania has a program called CHIP for children if you have kids. For yourself, definitely apply for Medicaid regardless of what the phone rep said. If denied, then go to healthcare.gov as the other person suggested. Your UC income will likely qualify you for significant subsidies.
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Aisha Rahman
•Thanks for the reminder about the work search - I completely forgot about that requirement! No PIN yet, but I only filed yesterday. No kids, so CHIP isn't an option, but I'll definitely still apply for Medicaid and check healthcare.gov as backup. Really appreciate the advice.
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Carmen Ortiz
THE SAME THING HAPPENED TO ME!!! The medicaid office is absolutely HORRIBLE with giving correct information over the phone!!! They told me I wouldn't qualify because of my last paycheck too, but then I got approved anyway a month later. The system looks at your CURRENT situation not just that one check. Apply online instead of calling - the website process worked better for me. Those phone reps just want to get you off the line!
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CosmicCrusader
•This is actually pretty common. The phone reps often give the most conservative answer so they don't promise something you won't get. The online application is definitely the way to go - it takes all your information into account properly.
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Andre Rousseau
When I got laid off back in February, I was in a similar situation with my medications being really expensive. Here's what I did: 1. Applied for Medicaid right away (got denied because of my severance payout) 2. Checked GoodRx for temporary medication discount (saved about 60% on my prescriptions) 3. Applied at healthcare.gov during my Special Enrollment Period 4. Got a Silver plan with cost-sharing reductions because my income was low My monthly premium ended up being about $85 after subsidies, which was manageable on UC benefits. The deductible wasn't great, but the medication copays were reasonable. Also, while you're waiting on your UC claim, if you're having trouble reaching someone at the PA UC office, I found this service called Claimyr (claimyr.com) that helped me get through to an actual person. They have a video showing how it works: https://youtu.be/CEPETxZdo9E?si=WL1ZzVZWG3KiHrg2. Saved me hours of busy signals and getting hung up on when I had issues with my claim.
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Carmen Ortiz
•GoodRx is a LIFESAVER!!! I saved like 75% on my blood pressure meds when I was between coverage. Some pharamcies give better discounts than others so check a few different ones if you can.
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Zoe Papadakis
i tried medicaid and marketplace when i lost my job... ended up going with marketplace bcuz i made too much from unemployment for medicaid... weird how that works. but just be careful, make sure u report ur income changes to healthcare.gov or they might make u pay back subsidies at tax time. happened to my cousin
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Aisha Rahman
•That's a really good point about reporting income changes - I hadn't thought of that. I'll definitely keep that in mind if I end up going with a Marketplace plan. Thanks for the tip!
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Jamal Carter
Just wanted to say that when I applied for PA UC last year, it took almost 6 weeks to get my first payment because I had an "open issue" on my claim that needed to be resolved. Make sure you have some emergency savings to cover that gap period. The health insurance stuff is stressful but don't forget about your other bills too. Hope it all works out for you.
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Aisha Rahman
•6 weeks?! Oh no... I don't have that much in savings. Do you know if there's any way to speed up the process? I'm going to be in serious trouble if it takes that long.
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CosmicCrusader
To answer your question about expediting UC claims - if your claim has no issues (like employer dispute or eligibility questions), you should get paid within 2-3 weeks. That other person's 6-week wait isn't typical unless there's a problem. One thing that might help: if your medication is critical, many pharmaceutical companies have patient assistance programs for people between insurance coverage. Google your medication name + "patient assistance program" and you might find help getting it for free or at a deep discount until your new insurance kicks in. And definitely file your weekly claims on time, even if you haven't received your first payment yet. They'll all get paid once your claim is approved.
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Aisha Rahman
•That's a huge relief to hear the 6 weeks isn't normal. I'll definitely look into the patient assistance programs - never heard of those before. And I'll make sure to file my weekly claims on time. Thanks again for all your help!
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Andre Rousseau
One more thing about your UC claim - make sure you answer the weekly certification questions correctly. If you make a mistake it can delay payments. The question about being "able and available for work" means physically able to work and available (not on vacation). Also, report ANY earnings during the week you earned them, not when you get paid. These are common mistakes that cause payment delays.
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Ethan Brown
•yep good advice! i messed up on one of my weekly claims and checked the wrong box by accident and my payment got held up for like 10 days while they sorted it out. read all the questions carefully!!!
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