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PUBLIC BENEFITS FOR PEOPLE AFFECTED BY COVID-19

Unemployment Benefits:

What is it?

Unemployment benefits is temporary income for eligible workers who lose their job through no fault of their own.

COVID-Related Notice:

New York State is waiving the 7-day waiting period for unemployment insurance benefits for people who are out of work due to COVID-19 closures or quarantines. If you live in another state, please follow up with your state’s unemployment office for COVID-19 updates.

To find out if you are eligible, how to file, what documents you need to file, and to contact the unemployment benefits office in your state, go to their website:

 

Supplemental Nutrition Assistance Program (SNAP)

What is it?

SNAP (or “food stamps”) provides eligible people with electronic benefits that can be used like cash to purchase food. The program is available in all 50 states.

To find out if you are eligible, how to apply, what documents you need to apply, and to contact the SNAP office near you, go to their website:

 

Social Security Disability Income (SSDI):

What is it?

SSDI is a Federal disability income program for adults who have worked and now find themselves unable to work due to a disability.

To find out if you are eligible, how to apply, what documents you need to apply, and to contact the SSDI office near you, go to their website:

If you have already applied and been denied benefits, you have 60 days to appeal. Contact your local SSDI office to appeal. If you are resident of New York City, you can call Legal Services NYC hotline for legal help in appealing your denial: (917) 661-4500.

 

Medicaid:

What is it?

Medicaid is a program for low-income persons whose income and/or resources are below certain levels.

Patients can enroll in Medicaid either through the HRA or the marketplace. A patient can apply for Medicaid through the HRA if they:

  1. Are over 65
  2. Need Medicaid because of a disability or blindness
  3. Get Medicare are not a parent or caretaker of minor children
  4. Are a former foster young adult under 26

Low-income pregnant women, children and adults under 65 must apply for coverage through NY State of Health, operated by New York State as part of the Health Plan Marketplace. Patients who are receiving, or who have received Medicaid coverage through the HRA should call the HRA Helpline at 1-888-692-6116.

New York State of Health

https://nystateofhealth.ny.gov/

Medicaid Spend-Down Program:

Because Medicaid is a health program for the low-income, individuals whose income is over Medicaid’s income guidelines would generally be ineligible for Medicaid. However, some individuals may be able to access Medicaid, despite being over-income. The “spenddown” refers to the amount of monthly income the household exceeds the monthly Medicaid “medically needy” income levels.

Once an individual incurs or pays for medical expenses equal to or greater than his/her spenddown amount in a calendar month, Medicaid will cover any additional medical expenses the individual incurs during that calendar month.

Patients are eligible for the spenddown if they are aged, blind, disabled, receiving SSD, under 21, a parent/caretaker/relative living in a family with children under 21, or pregnant and meet all Medicaid eligibility criteria, except income. The applicant’s income must be higher than Medicaid’s medically needy income guidelines.

Once an individual has paid or unpaid medical bills equal to or greater than their spenddown amount, the individual is eligible for Medicaid. In effect, the spenddown is like an insurance deductible.

Health Insurance Marketplace (Affordable Care Act):

What is it?

The marketplace is for people who don’t have health insurance through a job, Medicare, Medicaid, or another source that provides health coverage. A person can apply through the marketplace if they have job-based insurance, but must pay full price unless the employer’s insurance doesn’t meet certified standards.

If you want to learn more about this option, contact Callen-Lorde’s Facilitated Enrollment department: 212-271-7200.

To find out if you are eligible, how to apply, what documents you need to apply, and to contact the ACA office near you, go to their website:

Note: Individuals with Marketplace plans who are living with HIV can apply for ADAP through the NY Uninsured Care Program to get assistance paying for premiums. This does not apply to Medicaid recipients.

 

Health Coverage Options For The Recently Unemployed: COBRA

In general, most employers with 20 or more employees, who provide group health plans, must offer each “qualified beneficiary” who would otherwise lose coverage under the plan because of a “qualifying event” an opportunity to elect continuation of the coverage received immediately before the qualifying event.

A qualified beneficiary is any individual who, on the day before a qualifying event, is covered under a group health plan maintained by the employer of a covered employee by virtue of being 1) the covered employee; 2) a spouse or dependent of the covered employee.

A qualifying event is any of the following that would result in the loss of health insurance coverage:

1.       Death of the covered employee;

2.       Termination (other than for reasons of gross misconduct) of employment; or voluntary leave;

3.       Reduction in a covered employee’s hours of employment;

4.       Divorce or legal separation of a covered employee from the employee’s spouse;

5.       A covered employee becomes entitled to Medicare benefits;

6.       A dependent child ceasing to be a dependent child of the covered employee under the terms of the group health plan;

7.       With respect to certain retirees and their dependents, bankruptcy proceedings of an employer under Title 11 of the US Code, commencing on or after July 1, 1986.

If a qualifying event occurs, each qualified beneficiary is entitled to elect to continue to receive coverage identical to that being provided under the plan to “similarly situated beneficiaries” to whom a qualifying event has not occurred. If coverage for similarly situated beneficiaries under the plan is changed, coverage for qualified beneficiaries must be modified as well.

For any period of COBRA continuation coverage, a group health care plan can require a qualified beneficiary to pay an amount that does not exceed 102% of the applicable premium for that period. The qualified beneficiary who elects to continue coverage must pay for this coverage. The employee or qualified family member has the responsibility of informing the plan administrator within 60 days after the date of the qualifying event or the date that the qualified beneficiary would lose coverage due to a qualifying event.