There are currently 46 million people without health insurance in the United States. That number is continuing to trend upward as people are losing their jobs and their coverage. So, what do you do when you lose your health insurance?

There are several paths you can take. The most commonly known program is COBRA, which mandates that people must be able to retain their insurance coverage for up to 18 months after the end of employment. Under COBRA, the former employee is responsible for paying the entire insurance premium. Most people choose COBRA because it's easy and well-known. You simply complete the form provided by your former employer and pay the cost.

In addition, if you were recently laid off or fired and you are considering whether to enroll in COBRA the American Recovery and Reinvestment Act of 2009 mandates that employers pay 65% of the COBRA premium for "involuntarily terminated" employees. This new, temporary law applies to people involuntarily terminated from their jobs between September 1, 2008 and December 31, 2009. The subsidy will last 9 months.

Another option, however, is to purchase your own individual health insurance plan. This is a good option for people who are generally healthy, younger, and have some money saved up. There are two questions you should ask yourself before deciding to choose an individual insurance plan:

1. Do I have any health problems?
Even minor problems may disqualify you from health coverage. According to the insurance industry, 11% of applicants are turned down, but that number triples in applicants over the age of 60. If you have any pre-existing conditions, it's probably best to go with COBRA.

2. How often do I actually use my health insurance?
If you are using your insurance, you might want to consider raising your deductible and co-pay amount for office visits. Employer group plans often include many benefits not used by the individuals under the coverage. Why pay for those benefits if you are not going to use them?

Individual plans can be completed online at most major health carriers in your state. In the interim period between losing employment and choosing a new plan, it is smart to keep your COBRA and avoid any lapses in coverage. Once you say no to COBRA, you cannot go back.

You can also check out public insurance programs such as MediCal, and local community clinics. If you are not eligible now, you might be later.

Take Action:

• Find out more: go to the Foundation for Health Coverage.
• Download a COBRA Premium Reduction factsheet.
• Find a California health insurer.
• Find out about getting on MediCal.
• Find out about the San Mateo County Mobile Health Clinic.

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