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A Different Narrative

Tales from the bright side of healthcare.

A Novel Healthcare Option During a Novel Coronavirus Pandemic

June 24, 2020
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According to the Commonwealth Fund, health insurance plans from private employers cover around half of the U.S. population – which is why the rash of lay-offs and shutdowns in the wake of the corona-virus epidemic is exacting such a high toll on American workers. It is also why more people want to turn to alternatives models to find viable healthcare coverage in these unprecedented times.

The Situation

As the Coronavirus spreads and confirmed cases and deaths keep rising across the country, businesses are cautiously continuing to open. But even with these uneven baby steps to get back to some semblance of normalcy, the unemployment numbers are truly staggering. Per Fortune, as of the week ending May 28, more than 40.8 million people have filed for jobless claims since mid-March.  

The loss of a job is about more than a loss of income, however, as many newly unemployed workers are also at risk for losing health insurance. This is coming at a very bad time to be without insurance, as there is a heightened risk of infection from the coronavirus pandemic, especially in hard-hit areas and with the disease spiking again.

What are the Traditional Options?

There are several traditional options for health insurance if someone has just lost coverage. However, not everyone is eligible for all of these options and each has some significant drawbacks.

Coverage from a Family Member

One option for people to consider is gaining coverage from a family member if their own is lost. For instance, under the Affordable Care Act, young adults under the age of 26 can usually be added to their parents’ plans. Another option is to get onto your spouse’s insurance plan. However, for adults who are single and over 26 or for families where both breadwinners have been laid off, these are not viable options.

Medicaid

Medicaid is also an option to consider. However, the ease of getting Medicaid coverage will greatly depend on where you are living. According to the Kaiser Family Foundation, 36 states and the District of Columbia have adopted Medicaid expansion under the Affordable Care Act. However, if you are living in the southeast or parts of the Midwest, this expansion has not taken place. States which have not adopted Medicaid expansion include Tennessee, North and South Carolina, Florida, Georgia, Alabama, Mississippi, Kansas, Oklahoma, Wyoming, South Dakota and Wisconsin.

What is the difference in regards to Medicaid eligibility? In states which have adopted Medicaid expansion, an individual or family can receive Medicaid services based on income alone and this can occur when income dips below 133% above the national poverty level. In states which have not expanded their Medicaid programs, eligibility is based on a variety of factors, including income, presence of a disability, and family size and status.

Marketplace Coverage

The Marketplace established by the Affordable Care Act is also a place to turn for possible coverage. If you have lost employer-based insurance in the last 60 days or expect to lose it in the next 60 days, you can go onto the site and begin searching for possible healthcare plans, as losing coverage is considered to be a qualifying “life event”. However, it is important to note that this program is income-based and follows national guidelines from the Department of Health and Human Services and also that a substantial amount of paperwork is involved.

COBRA

The Consolidated Omnibus Budget Reconciliation Act (COBRA) was established in order to let patients keep employer-based insurance after voluntary or involuntary termination, reduction of work hours or other specific events.  The benefits can be extended for up to 18 months, though in some states this may vary.

However, health economist Linda Blumberg, when interviewed for Market Watch, noted that, “The catch is that you are now responsible for paying both your portion and your employer’s portion of the premium, plus a 2% administrative fee. This is not a cheap product.”  As a matter of fact, a survey from the Kaiser Family Foundation found that the average cost for an individual for health insurance in 2019 was $7,188 and $20,576 for a family. That is simply unaffordable for many families.

Where Ravel Comes In

So where does Ravel fit into this picture and how can it help with healthcare coverage options during these troubled times? Ravel was founded due to the collective frustration experienced by people having to pay an exorbitant amount of money to continually bang their heads against the wall of traditional offerings. It led to rethinking how healthcare is delivered in this country, simplifying it and cutting out the waste and excess.  

Ravel is not health insurance. Instead, it’s a way that patients and providers can interact directly with one another, while cutting out the middle man (i.e., the health insurance provider). The way it works is about as straight-forward as it gets: A patient searches for providers across primary, catastrophic and integrative/functional care, signs up when they find someone they like, adds that person or persons to their care team, pays a monthly subscription fee to see their doc, nutritionist, therapist, trainer, acupuncturist, etc., who in turn receives those payments directly from the patient, thus saving both money and hassle as compared to traditional healthcare plans.

In short, the COVID-19 pandemic has led to a mind-blowing loss of jobs and health insurance at a time almost unprecedented in American history. For those who have suddenly found themselves without healthcare coverage from employer-based plans, there are traditional options (such as Medicaid or the Marketplace) to consider, but all come with certain disadvantages and not all are affordable options for the average American household. This is a time when new methods of simplified, more direct healthcare delivery can come to forefront to revitalize an industry in great need of it. Join us in ushering in a new model that is truly win-win-win, for patients of course, but also for employers and providers.  

Ravel Profile
By Brian Wu
MD, PHD