Healthy Local 1: Frequently Asked Questions
Health insurance in complicated, and it’s important that we all understand our options. Click on any of the questions below to jump to the answer.
When does my health insurance expire?
Many employers have not paid into the health insurance of laid-off employees to keep people covered during the pandemic. If your employer does not pay for the health insurance, your health insurance will expire at the end of August or September (depending on which plan you have and when you last worked). We need to keep telling the companies that they should pay into your health insurance to keep us safe, especially during a pandemic. To check your file individually, you can always call the Unite Here Health Fund at 800-419-4373.
There’s also a bill in Congress, the HEROES Act, that would have the government help pay for COBRA premiums. We don’t yet know what law will get passed, or its effect on our healthcare. We’ll send out any updates as we have them.
What should I do before my healthcare expires?
- Fill out the Healthy Local 1 intake form HERE. We’ll send you a personalized recommendation for you and each person in your family, for what health insurance option we believe is the most accessible option that you’re eligible for. Look for an email with the subject line, “UNITE HERE Local 1 Health Insurance.”
- Schedule any doctor’s visits or services that you can before your Union health insurance expires. If you take prescriptions, call the UH Health Clinic or your pharmacy to schedule delivery of 3 months of your medication. If you need glasses or want to use your vision benefits, do so HERE while your healthcare is active.
- Then, find the best alternative to your union health insurance plan with the information below.
OK, so my Union health insurance is expiring. Can I keep my current insurance? Can I just pay my union dues to continue my insurance coverage?
You can’t keep your current health insurance just by paying Union dues. Your healthcare is paid for by the companies, because we’ve shown them that we are powerful together. Your dues don’t pay for healthcare – they pay for us to build a fighting union.
If you’ve been in a Union health insurance plan, you can enroll in COBRA, which continues your same healthcare as before. If you were on a company health insurance plan before being laid off, you can also apply for COBRA through that plan. The rates and coverage for a company health insurance plan will be different than what’s below. Under COBRA, you’re responsible for the part of the payments that the company would have been paying for you if you had not been laid off. That means that COBRA is costly for individuals, and very expensive for families. Below are the rates for how much COBRA coverage of Union health insurance will cost once the Union healthcare ends. We understand that the family rates aren’t possible for most people.
How expensive is COBRA insurance through the Union?
|Single + Spouse||$1,655.66||$21.39||$4.56|
|Single + Child(ren)||$1,294.72||$16.73||$3.57|
COBRA looks really expensive. What are my other options?
If you’re 65 or older, we recommend that you sign up for Medicare. As a federal health care insurance program, it is largely the same in Illinois and Indiana. It generally covers 80% of medical services (although you have to meet a deductible and there is cost-sharing). Younger people with certain disabilities are also eligible, as well as people with End-Stage Renal Disease. You must be a citizen or lawful permanent resident.
If you’re under 65, let’s talk about Medicaid (a.k.a. CountyCare, KidCare, Medical Card). You must make less than a certain income level, determined by your family size. You must be a resident of the state in where you apply for benefits. Citizens are eligible, and you may be eligible if you’re a qualified non-citizen who has been a resident for more than 5 years. There are some exceptions to the 5 year requirement, such as for refugees, asylees, Cuban/Haitian entrants, trafficking victims, and veteran families. Medicaid is a good state-administered program that provides comprehensive coverage for many medical needs. If you’re eligible for Medicaid, we recommend using this option. Click HERE for a step-by-step guide on how to apply for Medicaid.
How do I know if I’m eligible for Medicaid?
If your monthly family income is below these numbers and you meet the residency/citizenship requirements, then you are likely eligible for Medicaid.
Note: While children ages 19-25 can be on your Union health insurance, they CANNOT apply with you on Medicaid, so they do not count in your family size. They may be eligible to apply on their own.
Also, if you haven’t filled it out already, fill out the intake form HERE and we can tell you, based on your answers, if we think you may or may not be eligible for Medicaid.
ILLINOIS 2020 Medicaid Guidelines
|Family Size||Max Monthly Family Income for
Medicaid for Children
(0-18 years old)
|Max Monthly Family Income forMoms & Babies program
(include unborn child in family size)
|Max Monthly Family Income for
Medicaid for Adults
(19+ years old)
Source: http://www.dhs.state.il.us/OneNetLibrary/5/documents/WAG_25_03_02_uploads/2020_03_01_WAG_25_03_02_Final.pdf, Last updated 9/2/20.
INDIANA 2020 Medicaid Guidelines
|Family Size||Max Monthly Family Income for
Medicaid for Children
(0-18 years old)
|Max Monthly Family Income forPregnant Women (include unborn child in family size)||Max Monthly Family Income for
Medicaid for Adults
(19+ years old)
Source: https://www.in.gov/medicaid/members/59.htm,Last updated 9/2/20.
What do I do if I can’t afford COBRA and I’m not eligible for Medicare and Medicaid?
Your next-best option is to go to a Federally Qualified Health Center (FQHC). These centers offer affordable, comprehensive care in your community. They often offer a range of services, such as appointments with a physician, pharmacy services, vision care, dental care, and counseling. Many have Telehealth services. They do not offer on-site hospitalization.
The price of services depends on your income, but it should be affordable either way. Go ahead and make a first appointment.It’ll help for future medical needs to be an existing patient rather than a new patient.
- Click HERE to see if you’ll pay on a normal rate or a sliding scale.
- Coming soon: a list of FQHCs in Chicagoland and Northwest Indiana, and more info about the services provided at each one.
What are the downsides to each plan?
Medicaid: Coverage is generally good, although you may not have as much choice of doctors as you currently do on the Union insurance plan. Some services will need prior authorization to be covered. Medicaid also often covers the generic brands of medicine but not the name-brand version.
Medicare: Many members do not qualify based on eligibility requirements
COBRA: If you had Union health insurance, you can continue your great coverage, but it is expensive. For Individual Medical/Dental/ Vision, the premiums range from $458.42 per month to $788.38 per month. Family coverage is significantly more expensive than that.
FQHCs: Services depend on which site you go to (i.e. not every site will have a full range of services). Cost will depend on your income, so you may or may not be able to pay based on a sliding scale.
We went on strike in the hotels and won year-round healthcare! Why is it expiring during these layoffs?
In the 2018 hotel strike, we won historic language to protect our healthcare. Companies must pay healthcare contributions through the winter months (specifically, December, January, February, and March) when people in the hospitality industry are most often laid off. Our hotel healthcare is paid 3 months in advance – if the company pays your healthcare contribution in December, that gives you coverage in March.
The last date many employers paid for healthcare was when employees were laid off. Because many employees did not go back to work, the Union health fund made contributions for the following months to make sure workers were covered. But without further contributions from the employers, the coverage will end. Based on the current state of the pandemic, it is likely that many members will not go back to work until later this year or next, which will cause a gap in coverage for most people. We want to make sure people find health care coverage for at least that time, if not longer. When employees go back to work, coverage will start 3 months after returning to work. If you have further questions, call the Unite Here Health Fund at 800-419-4373.
How much can I expect to pay under each plan?
Medicaid: Generally, it is free for those who qualify. Exact costs and coverage will depend on your age, income, and if you live in Illinois or Indiana. In general, plans offer 100% coverage for a range of primary health services, with no co-pays, premiums, or deductibles. Most plans cover services for adults and kids like doctor visits and dental care, immunizations for children, therapy and counseling, hospital visits, and some prescription drugs.
Medicare: Medicare has 3 parts: Part A (Hospital insurance), Part B (Medical insurance), and Part D (Prescription coverage). Most do not pay a premium for Part A coverage, but there is a deductible. You will also typically pay a premium for Part B coverage. The standard Part B premium in 2020 is $144.60, but the exact amount depends on your income. After meeting the deductible, you typically pay 20% of the Medicare-approved medical services. You also have a premium, deductible, and cost-share for Part D coverage.
COBRA: This is the same coverage you had from before the layoff, but you pay the part of the insurance premium that the company paid while you were working. For example, in the Union health insurance plan for hotel workers, the coverage for individuals is the same (100% coverage with largely no co-pays). But the premium is about $500 per month instead of being free, to cover the part that used to be paid by the company. Family plan coverage can be more than double that amount. If you were on a company healthcare plan, the premiums will likely be cheaper, but for less comprehensive coverage.
FQHCs: The cost of the services will depend on your income. If you fall below a certain income (dependent on family size), you’ll pay on a sliding scale. If you make above a certain income, the cost will not be sliding-scale, but is usually affordable. You can check HERE to see whether the cost to you of services at an FQHC will be sliding scale or not.
How do I enroll in each of these plans?
Medicare: Apply online at https://www.ssa.gov/benefits/medicare/
COBRA: You’ll get a “COBRA Notice” letter in the mail from Unite Here Health when your benefits are about to expire. If you’re on Union health insurance, we’ll be sending out these letters soon. Follow the directions on that letter. If you’re on a company plan, call your company to have them send you one if you have not received one. Please note: It is important that you select coverage and pay premiums within the timeframes specified in the notice. If you miss a deadline, then the plan is not required to reinstate your coverage.
FQHCs: Call an FQHC to get your first appointment set up so that you’re in their system. It is often easier to get follow-up appointments once you’ve had a first session. If you’ve filled out the Healthy Local 1 Intake survey, in the email we sent you for healthcare recommendations (subject line “UNITE HERE Local 1 Health Insurance”), we included a list of the FQHCs closest to you.
I’m pregnant. What am I going to do when the Union healthcare expires?
Pregnant people may be eligible for Medicaid, through their pregnancy and for up to 60 days after the birth of the child. Likely (depending on your family income), the child will also qualify for Medicaid after that 60 day period. In Illinois, residency/citizenship requirements are waived for pregnant people.
What do I do about my Life Insurance?
Life insurance, paid for as part of the health insurance, will discontinue when the health insurance expires. It is separate from COBRA (whether or not you enroll in COBRA, it will expire). However, you will be able to continue your life insurance policy, separate from the health insurance, for about $30/month.
Can I apply early for other healthcare plans before my Union health insurance expires? Is it bad to have both at once?
Prepare ahead! It’s good to go ahead and file for another form of healthcare now, before your Union healthcare expires. In fact, Medicaid applications can take 4-6 weeks to be approved once you file, so don’t wait until the last minute. Similarly, if you’re going to use FQHCs, it is best to call ahead and make a first appointment now so that you’ll be in their system. While your Union healthcare is active, that will be your “primary” healthcare, and will be the first one that gets billed by a healthcare provider. Once your Union healthcare expires, we’ll walk you through how to make your other healthcare, like Medicaid, your main health insurance.