Employer based health insurance provides coverage for tens of millions of Americans. Unfortunately, many employees will be without coverage if they lose their job, quit, retire or if their company goes out of business. In most cases, an employee can elect COBRA upon losing employment. The Consolidated Omnibus Budget Reconciliation Act will provide 18 months of additional coverage so long as the group consisted of 20 or more employees. In Ohio, if the group is under 20 employees COBRA allows for up to six months of coverage. This law is sometimes referred to as “Baby COBRA.”
There are certain rules regarding who is eligible to elect COBRA and what the cost will be, but in all cases COBRA is temporary insurance for the insured. In addition, the expense to the former employee can be significant. Ultimately, the cost will be determined by the premiums for the former plan plus a 2% administrative fee. Former employees are often surprised to discover how much it will cost to elect their company insurance through COBRA.
Individual Health Policies for Healthy Consumers
Once their COBRA benefits have run out, individuals and families will need to search the individual health market. If you are in good health, usually there are few problems obtaining an individual or family policy. However, if the former insured is in poor health – finding a comprehensive policy can be very difficult. There are providers who will insure high risk individuals, but typically the benefits to the insured are far less than their employer sponsored plan. When possible, an individual in poor health may only be able to find adequate coverage in another employer sponsored plan. The state of Ohio does offer an HMO plan providing open enrollment with select companies. The coverage offered will vary by county and the enrollment window will differ from company to company. However, you can expect these plans to be very expensive.
Purchasing Permanent Coverage
Thus, it is advisable to explore your options as soon as you lose your employer sponsored coverage. COBRA can be helpful, but because it is not permanent, new coverage will usually be needed at some point. One potentially difficult scenario can be easily avoided by shopping for insurance early. Electing COBRA while in good health and waiting to apply for permanent coverage until the allotted 18 months expires is a risky proposition. What if your health changed for the worse during that period of time? You may have difficulty finding coverage in the individual market. However, you would have been insurable had you applied for a plan immediately after becoming unemployed. In many cases, the permanent individual coverage would be less expensive as well.
In summary it is always advisable to obtain permanent health insurance coverage while you are in good health. Once accepted, you can keep this coverage for as long as you need it. If you rejoin a group plan later, you may elect to drop the coverage or maintain it if you feel that you have a superior plan.
By: Adam Hyers
Archive for November, 2009
Health Insurance Options and COBRA Insurance
November 30th, 2009Posted in Articles
Tags: Adequate Coverage Baby Cobra Budget Reconciliation Act Cobra Benefits Cobra Insurance Company Insurance Consolidated Omnibus Budget Consolidated Omnibus Budget Reconciliation Consolidated Omnibus Budget Reconciliation Act Enrollment Window Health Insurance Options Health Market Hmo Plan Individual Health Policies Omnibus Budget Reconciliation Omnibus Budget Reconciliation Act Poor Health Risk Individuals Select Companies Temporary Insurance
Low Cost Health Insurance In Texas
November 29th, 2009
Texas health insurance options are pretty good if you need to get individual or family health insurance because you are self-employed or it’s not available any other way. There are different types of plans, and costs and coverages can vary quite a bit. Here’s how you can find health insurance coverage.
Like in most states, you can get health insurance in Texas that basically falls into two categories: Fee-for-service and managed care.
Fee-for-service: With this type of health insurance policy, you can see any doctor or provider you want and typically go to a specialist without a referral. The provider may bill the insurance company, or you will need to submit a claim form to the health insurance company to reimburse you for the expenses that they cover. The insurance company may cover from 80 to 100 percent of the expenses. You will pay a premium, a deductible, probably a coinsurance amount and will have a maximum yearly limit to your coverage. Texas law requires health insurance companies to pay claims promptly.
Managed care: A managed care plan uses doctors, hospitals, and other providers that are associated in a network. You would become a member of an HMO, PPO or POS network and usually have to use the providers in the group to receive benefits. This put some limitations on who you can visit for health care, but these plans usually provide an affordable health insurance alternative to fee-for-service. Also, Texas law is very comprehensive about protecting your rights when you join a network.
You should get several quotes when shopping for health insurance — at least three. In Texas, one of the easiest ways to get multiple quotes is to go online to an insurance comparison site. These sites allow you to enter your information into a “quote box” or form, and then they’ll provide you with multiple quotes from different companies or agents. Since coverages and plans all differ, make sure to see if the plan you like is giving you the service and coverages that you and your family needs.
By: Scott Lunt
Posted in Articles
Tags: Affordable Health Insurance Claim Form Different Companies Family Health Insurance Health Care Health Insurance Health Insurance Companies Health Insurance Company Health Insurance Coverage Health Insurance Options Health Insurance Policy Insurance Comparison Insurance Health Low Cost Health Low Cost Health Insurance Low Cost Health Insurance In Texas Ppo Protecting Your Rights Referral Texas Health Insurance
Low Cost Health Insurance Revealed – Most Common Health Insurance Questions
November 28th, 2009
Understanding health insurance plans is very confusing for most consumers. It doesn’t matter whether you buying health insurance for the first time or just want to consider changing plans. We spoke to some of the industry experts and got answer to some of the most frequently asked questions.
What kinds of individual and family insurance plans are available?
There are three types of Individual and family health insurance plans described as either “indemnity”,”PPO” and “managed-care” plans. Put broadly, the major differences concern choice of healthcare providers, out-of-pocket costs and how bills are paid. Typically, PPO plans offer a broader selection of healthcare providers than managed care plans. Indemnity plans pay their share of the costs for covered services only after they receive a bill (which means that you may have to pay up front and then obtain reimbursement from your health insurance company).
There are several different types of health insurance plans. These include HMO, PPO, and POS plans. HMO’s are managed care as the insurance company determines who your doctors are and what care you will receive. POS plans are geographically focused plans that are a cross between a HMO and PPO. PPO’s make use of healthcare provider networks and you are free to choose your own doctors within the network. Healthcare providers within a network agree to perform services for PPO plan patients at pre-negotiated rates and will usually submit the claim to the insurance company for you. In general, you’ll have less paperwork and lower out-of-pocket costs with a PPO health insurance plan. You’ll have an even broader choice of healthcare providers with an indemnity plan because there is not network; it’s any doctor, any hospital, anywhere.
When can I start making appointments with my physician?
For individual insurance coverage, it depends on how long it takes for your enrollment papers to be processed through underwriting and how long it takes to review your medical records for preexisting conditions. It may take anywhere from two weeks to three months after you have submitted your enrollment paperwork plan carrier to complete underwriting. This delay depends on how long it takes to get records from your physician. Your policy only becomes effective when underwriting is completed and the insurer has agreed to issue a policy. You may see your physician after the effective date.
My spouse is losing his/her job and won’t have insurance. When can I add him/her to my health insurance?
If you have group insurance, you may add you spouse during the open enrollment period. But for individual insurance, you may submit you spouse’s application and proceed through the enrollment process at any time.
How do I change health plans?
Each year during the open enrollment period, you may elect to change your health plan carrier under group insurance. You may change your plan at anytime if you have individual insurance.
Are there preexisting condition limitations if I change health plans?
There is no preexisting condition limitation under your new plan when you transfer plans under group insurance. Any condition for which you are receiving treatment prior to your coverage change will be covered immediately by your new plan.
What happens to my health insurance when I retire?
This can be a scary situation. Retirement typically means you are older and may have a possible accumulation of preexisting conditions, which could make you uninsurable, or your preexisting conditions could be excluded. Meaning, you suddenly have to cover the cost of expensive meds or care. Fortunately, Colorado is one of 26 states that provide a safety net through a high risk uninsurable pool. If you have had coverage within 60 days, your preexisting conditions are covered immediately. Otherwise your preexisting conditions will be covered within six months as long as you are a resident of Colorado. You may find further information about this type of coverage at http://www.covercolorado.org.
What happens to my health insurance when I resign from a job?
You are entitled to continue the health coverage for up to 18 months under a Federal law referred to as COBRA. Cost of coverage is borne fully by the employee.
We will be having a child soon. How do I add this child to my health and dental insurance coverage?
You may notify and add new born children within 30 days of their birth date. Adopted children may be added after they fill out an application and go through the enrollment process.
By: Bruce D Hunter
Posted in Articles
Tags: Buying Health Insurance Common Health Family Health Insurance Family Insurance Plans Health Insurance Health Insurance Company Health Insurance Plan Health Insurance Plans Health Insurance Questions Healthcare Providers Indemnity Plan Indemnity Plans Individual Insurance Coverage Industry Experts Low Cost Health Low Cost Health Insurance Ppo Insurance Provider Networks Several Different Types Understanding Health Insurance
