Continuum of care

5 ways to go with health insurance if you're laid off
By Dana Dratch, Bankrate.com

If you've been laid off, the first things you think about are keeping food on the table and bill collectors away from the door. But there is one intangible you really do need: health insurance. Once you leave your job -- because you were laid off, quit or were fired -- you basically have five choices on health insurance: continue on your current group plan and pay the premiums yourself, enroll in your spouse's plan, buy individual insurance, use a state-sponsored plan or -- the worst of all worlds -- go without.
Get the factsProblem: Insurance laws vary from state to state, the language is confusing and even experts don't have all the answers. You need a quick overview of your situation.

Solution: Call your state insurance commissioner's office, ask for a consumer representative and have that person walk you through your options. "It's a free call, it's a free service and an objective third party who knows the market can help you sift through the options," says Kathleen Sebelius, the Kansas insurance commissioner and president of the National Association of Insurance Commissioners. It's also less stressful than playing phone tag with your former employer and easier than trying to decode reams of insurance paperwork on your own. Don't be afraid to ask questions. The most important one: Find out what deadlines you have to meet to keep your options open on insurance and what coverage options are available in your state.

Option 1: COBRAThe Consolidated Omnibus Budget Reconciliation Act of 1986 -- popularly known as COBRA -- allows you to keep your current insurance coverage for at least 18 months after you leave your job. The downside: you have to pay all the premiums yourself -- and that can get expensive. Even a healthy 20- to 30-something can count on a monthly bill of $200 to $300. Patricia Yoon, 25, used COBRA for a couple of months when she was laid off two years ago. "I did think it was expensive -- $200-$250," a month, says Yoon, who was laid off again in June. "It's tough, especially when you're young and saving is not a priority -- when you're living hand to mouth." But don't let the cost scare you off. "It's one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition," says Paul Fronstin, a senior research associate with the Employee Benefit Research Institute, a nonprofit organization that studies benefits and related issues. Since you're continuing your current coverage, you can't be dropped or face exclusions. And because it's a group plan, the carrier can't single you out for a rate increase if your care gets expensive.
COBRA is "one of a handful of options, but it might be the best one out there, especially for a person with a pre-existing condition."
— Paul Fronstin, Employee Benefit Research InstituteFederal law guarantees that if you maintain group coverage without a 63-day gap, you and your dependents won't face any exclusions when you find work and enroll in another group plan. Your employer can require a waiting period, as long as it applies equally to everyone, but cannot exclude you because of a pre-existing condition.

COBRA is available only if you worked for a company with 20 or more employees, had health insurance through your employer and your former employer is still in business. The idea of COBRA is that you piggyback on another group plan. If that plan doesn't exist because the company went under, there is no COBRA. If your company offers COBRA, sign up -- whether you can afford the payments or not. Why? Between the deadline to apply and the date the first payment is due, you have more than three months to get another position, find a better insurance deal on your own or get a part-time job to make the COBRA payments. But if you do have a calamity, chances are that COBRA premium will be a lot cheaper than the hospital bill. "It's tough medicine because when you're laid off it's really a challenge to pay those COBRA bills," says Gail Shearer, director of health policy analysis for the Washington, D.C., office of Consumers Union, the group that publishes Consumer Reports magazine.

Option 2: Your spouse's plan-Obviously, this is not an option for everyone. Compare the cost and the coverage to what you would have with your own COBRA plan. One big plus: If you're moving from one group plan directly to your spouse's plan, you can't be excluded for any pre-existing health condition, such as a pregnancy.

Before you sign on the dotted line, ask yourself two questions: How stable is your spouse's job and how strong is your relationship. If your spouse gets sacked, both of you will be stuck with the COBRA version of your spouse's plan. Ditto if you divorce.

Option 3: Individual insurance- Shopping for an individual insurance policy is a lot like buying a car -- only more confusing. Best advice: Start shopping for health insurance as soon as you lose your job. Whether you're going to build your own business, temp or look for a new position, make securing health insurance a priority. Again, your state insurance commissioner's office is a great resource -- and one of the few that doesn't have a financial stake in your decision. They can tell you about complaints against a company, the firm's reputation and its financial stability. Be realistic -- virtually all insurance firms will have had some complaints. Make a list of insurance companies or HMOs you want to investigate. Don't know where to start shopping? Call the company that your former employer used, if you liked the coverage. Ask friends and family members what companies they use -- and if they are satisfied. Check with your doctors to learn what plans they honor. That should give you a good start. Next, make a list of coverage options that are important to you. Do you want access to specific doctors or facilities? Do you need low-cost prescription refills? How much do you want to pay for a doctor visit? Are you just looking for a high-deductible policy to cover catastrophic situations? Do you want access to alternative therapies? Now contact the companies on your first list and see how their coverage matches up with your wish list. Look at four things: how much are premiums, what will the policy cover, what will it exclude and how much is a doctor visit. Before you sign up, research the stability and service reputation of your picks. Several companies study the financial strength of insurance companies, HMOs or both. A few of the top ratings firms are Standard and Poor's, A.M. Best, Moody's Investor Service and Weiss Ratings. If you want to know how a prospective company stacks up on the customer service end, check out its ranking with the four major accreditation agencies: the National Committee for Quality Assurance, the Accreditation Association for Ambulatory Health Care, the Joint Commission on Accreditation of Health Care Organizations and URAC, the American Accreditation HealthCare Commission. The rule with individual insurance: you pay more, you get less. Conversely, group policies "tend to get more bang for the buck and avoid the problems of the individual market," says Shearer. And be aware: There is no guarantee you'll be able to purchase an individual policy. But if you can't afford COBRA and don't have a spouse, an individual policy may be your best choice. Read the fine print, shop smart and know your state regulations.

Option 4: State-sponsored plans What if your former company is too small to qualify under COBRA or the company's gone under? You may be eligible for a state insurance pool. Under federal law, every state must provide this choice, sometimes called a high-risk pool. In theory, you pay the premium and, in turn, reap the reward of group coverage. You can also use a state pool if you exhaust your COBRA coverage -- usually after 18 months -- and still don't have another job. But the jury is still out on whether the plans are a hit or a miss. "High-risk pools have not been a tremendous success story from our point of view," says Shearer, citing high premiums for limited coverage, waiting lists and only an estimated 100,000 people in the pools nationwide. "The picture's not pretty." Every state also has a low-cost health insurance plan for children. You don't necessarily have to have a low income to qualify. If you have children under 18, ask about the plan when you talk to the state insurance commissioner's office. A national toll-free number, (877) KIDSNOW, will connect you with the children's insurance program in your state. Children are eligible up to age 19.

Option 5: No insuranceJoining the ranks of this country's 42 million uninsured is not a good option. Going without insurance puts both your physical and financial health in peril, as medical bills are the fourth-biggest reason people go into serious debt, according to statistics from the National Foundation for Credit Counseling. If you can't afford anything else, at least pick up a catastrophic insurance policy. While it won't cover every doctor visit -- or be as cheap as you might expect -- at least you won't be wiped out if you or a family member become seriously ill.
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Afforadable Travel Insurance

Discover how afforadable travel insurance is. Our goal is to make this online process easy from quoting to applying to receiving! If you or a loved one seriously became ill while traveling overseas what would you do? Could you understand the language well enough to approve a major surgery? Did you know... most domestic medical insurance plans aren't accepted when you travel internationally. Please visit www.insurancedfw.com for an affordable quote on afforadable travel insurance.

Health: What You Need to Know in Advance of Travel

All travelers should familiarize themselves with conditions at their destination that could affect their health (high altitude or pollution, types of medical facilities, required immunizations, availability of required pharmaceuticals, etc.). While some of this information may be found in the documents listed above, the key resource for health information is the Travelers’ Health page of the Centers for Disease Control (CDC) website at http://www.cdc.gov/travel. The CDC website also provides general guidance on health precautions, such as safe food and water precautions and insect-bite protection. The CDC also maintains an international travelers' hotline at 1-877-FYI-TRIP (1-877-394-8747).

Vaccination, Infectious Diseases, Pandemic Influenza, Foot & Mouth Disease, Chemical/Biological/Nuclear Incidents
General guidance on vaccinations and other health precautions may be found on the Travelers’ Health page of the Centers for Disease Control (CDC) website at http://www.cdc.gov/travel.
Fact Sheets on foot and mouth disease, responding to chemical, biological, radiological or nuclear incidents and other health issues, including pandemic influenza, may be found at http://travel.state.gov/travel/tips/brochures/brochures_1215.html.
For information about pandemic influenza, see http://www.pandemicflu.gov/ or the website above. Information about infectious diseases abroad may also be found on the website of the World Health Organization at http://www.who.int/en, and further health information for travelers is available at http://www.who.int/ith.

Insurance, Medicare & Medicaid, Medical Evacuation
Obtaining medical treatment and hospital care abroad can be expensive, and medical evacuation to the U.S. can cost more than $50,000. Note that U.S. medical insurance is generally not accepted outside the United States, nor do the Social Security Medicare and Medicaid programs provide coverage for hospital or medical costs outside the United States.
If your insurance policy does not cover you abroad, it is a good idea to consider purchasing a short-term policy that does. There are health insurance policies designed specifically to cover travel. Look for insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations. See http://www.insurancedfw.com/ to purchase insurance policy.

Bringing Medications or Filling Prescriptions Abroad
A traveler going abroad with a preexisting medical problem should carry a letter from the attending physician, describing the medical condition and any prescription medications, including the generic names of prescribed drugs. Any medications being carried overseas should be left in their original containers and be clearly labeled. Travelers should check with the foreign embassy of the country they are visiting to make sure any required medications are not considered to be illegal narcotics. (A listing of foreign embassies and consulates in the U.S. is available on the Department of State’s website at http://www.state.gov/s/cpr/rls/dpl/32122.htm. Foreign embassy and consulate contact information can also be found on the Country Specific Information for each country.)

If you wear eyeglasses, take an extra pair with you. Pack medicines and extra eyeglasses in your hand luggage so they will be available in case your checked luggage is lost. To be extra secure, pack a backup supply of medicines and an additional pair of eyeglasses in your checked luggage.

If you have allergies, reactions to certain medications, foods, or insect bites, or other unique medical problems, consider wearing a “medical alert” bracelet. You may also wish to carry a letter from your physician explaining required treatment should you become ill.

Discover how afforadable travel insurance is.
Our goal is to make this online process easy from quoting to applying to receiving! If you or a loved one seriously became ill while traveling overseas what would you do? Could you understand the language well enough to approve a major surgery? Did you know... most domestic medical insurance plans aren't accepted when you travel internationally.

2010 budget and health care priorities

President Obama releases 2010 budget and health care priorities.

President Obama provided a budget outline that highlights the priorities for his Administration, including eight principles for health care reform: 1) protecting families' financial health; 2) ensuring that coverage is affordable; 3) aiming for universality; 4) achieving portability of coverage; 5) guaranteeing choice; 6) investing in prevention and wellness; 7) improving patient safety and quality of care; and 8) maintaining long-term fiscal sustainability. Although no specific proposals for health care reform are provided to address these eight principles, the President's budget includes a 10 year $634 billion reserve fund for health care reform. The President has stated that the reserve fund will not fully fund comprehensive reform of the health care system and that he will work with Congress to find additional resources.
For more info: President Obama's 2010 Budget proposal - www.whitehouse.gov/omb/budget

COBRA Provisions in the American Recovery

It is important to keep in mind that this law is still very new and there are still many unanswered questions.

The American Recovery and Reinvestment Act (the "Act"), signed by President Obama on February 17, 2009, introduces a 65 percent subsidy of COBRA premiums for certain individuals.

Congress has passed the American Recovery and Reinvestment Act ("the Act"), and the Act has been signed by President Obama. This communication describes the provisions in the Act that affect COBRA continuation coverage and similar state continuation coverage.

Applicability and Effective Date
The COBRA changes affect both the federal COBRA provisions and the Public Health Service Act program that provides similar extension benefits for public programs. In addition, however, the subsidy provisions apply to state continuation coverage that is comparable to federal COBRA. That would include so-called "mini-COBRA" state laws that cover groups below the 20 employee threshold for COBRA. To be comparable, the state continuation law must allow the individual to continue substantially similar coverage as was provided under the group health plan at a monthly cost that is based on a specified percentage of the group health plan's cost of providing such coverage. Reference to "COBRA" throughout this memo will also refer to the state programs that meet those requirements.

The Act is effective February 17, 2009, the day that President Obama signed the bill. All of the COBRA provisions that have a time frame will date from that day. As for calendar monthly billed programs, the effective date is March 1, 2009.

New Subsidy for COBRA Beneficiaries
The Act provides for a new subsidy for certain COBRA beneficiaries. The subsidy is 65% of the COBRA continuation coverage premiums for eligible individuals for up to 9 months. The COBRA beneficiary will pay only 35% of the overall COBRA premium for that period. The period expires on the earlier of (i) nine months, (ii) the date the individual becomes eligible for major medical group coverage or Medicare or (iii) the end of the maximum required period of continuation under COBRA. Further, the beneficiary must notify the employer in writing if they become eligible for coverage under a major medical group health plan or Medicare and is subject to significant penalties (110% of the subsidy amount) for failing to do so.

An individual who does not receive a subsidy that he/she believes appropriate may appeal the plan's determination to the Department of Labor for private plans or to the Department of Health and Human Services for public plans covered under the Public Health Services Act. The relevant agency must rule on the appeal within 15 business days. Individuals whose appeal is denied may sue under ERISA.

Eligibility for the Subsidy - Timing
The subsidy is available to individuals (and their dependents) who were involuntarily terminated from their employment and became eligible for COBRA beginning September 1, 2008 through December 31, 2009. Persons who elected prior to the enactment of the Act (but on or after September 1, 2008) will be eligible to receive the subsidy prospectively from the date of enactment through the maximum nine-month period. Otherwise eligible persons who did not elect COBRA between September 1, 2008 and the date of enactment will have the opportunity to elect COBRA on a prospective basis with the maximum duration of the coverage dating from the date that they could have first elected COBRA. Employers or plans will have to provide notice to these groups of individuals. In addition, a group health plan or insurer must refund the individuals any COBRA premiums that subsidy-eligible persons paid on or after the date of enactment in excess of 35% of the premium. This may be in the form of a reimbursement payment or credit against future premium payments due.

Eligibility for the Subsidy - Income Test
The subsidy is adjusted based on income. Joint filers with $250,000 or more of modified adjusted gross income and all other filers with $125,000 or more of modified adjusted gross income are not eligible for the full subsidy. The subsidy is phased out completely for persons with modified adjusted gross incomes of $290,000 joint or $145,000 for other filers. The subsidy is not considered income as long as the beneficiary meets the income tests. Excess amounts of subsidy over the amount the person is entitled to by income will be added to the person's tax on the person's federal tax return. The employer will not have to be concerned about the taxable effect on COBRA beneficiaries although a COBRA beneficiary may request that the employer not provide any subsidy.

Mechanics of the Premium Subsidy
The Act requires that the relevant entity that is collecting the 35% premium simply not collect the remaining 65% and, instead, obtain reimbursement from the federal government. In cases of a multiemployer plan, a group health plan subject to federal COBRA and/or a self-funded employer, the plan or the employer that is collecting the premium will recoup the subsidy amounts through commensurate reductions in payroll taxes. For insured plans not subject to federal COBRA, where the insurer is collecting the premium, the insurance company will be entitled to the reimbursement through a corresponding credit to its own payroll taxes. In cases where the payroll taxes are not sufficient to cover the subsidy, the additional amount will be provided as a credit to the taxpayer as if it was an overpayment of payroll taxes. There are filings that payers receiving the subsidy must make with the Secretary of the Treasury.

Electing a Different COBRA OptionA
n employer may allow a COBRA-subsidy eligible individual to change his or her health insurance coverage option when making a COBRA election. The new plan option must be made within 90 days of receipt of the COBRA election notice, must have the same or lower premiums and must be available to non-COBRA active employees under the plan.

Notice Requirements and Election PeriodUnder the Act employers must provide modified election notices or provide separate supplemental notices to all persons who became entitled to elect COBRA continuation coverage during the period beginning on September 1, 2008 and ending on December 31, 2009.
The new forms would notify the individual about the subsidy and, if applicable, the right to change to different benefits options. The Department of Labor, Treasury and Health and Human Services are supposed to work together to provide a model notice within 30 days of enactment.

Notices are required to be sent to subsidy-eligible persons who became qualified beneficiaries before the date of enactment within 60 days of enactment. (The Act does not affect the timing of notices sent to individuals who become qualified beneficiaries on or after the date of enactment.) The election period for those beneficiaries who became eligible before the date of enactment will begin on the date of enactment and end 60 days after the date the plan administrator provides the required notice.

Failure to provide the notices would be a COBRA violation and subject to the standard COBRA penalties of up to $110 a day under ERISA. Additionally, there could be adverse tax consequences under the Internal Revenue Code, which can impose excise taxes of $100 per day per notice on the plan administrator.

This overview is provided for your information only and does not constitute legal advice. If you need legal advice, you must seek the opinion of a qualified attorney.

Laid off and needing medical insurance in Texas

There is an affordable solution

In a bleak report on Friday, the Labor Department said that almost 600,000 jobs disappeared in January and that a total of 3.6 million jobs had been lost since the beginning of the recession in December 2007. *

In this economy with forced layoffs, many good jobs with health benefits have disappeared. Since many people are covered through their employer's insurance, when they lose their jobs they are forced to take the expensive and unaffordable continuation of benefits or they lose health benefits altogether. For each jobless worker who has lost insurance, children and spouse have also lost protection. This group of individuals is opting to cancel appointments with doctors and dentists, putting off surgery, and going without prescription medicines for themselves and their children to not spend money.

You know the financial risk of going without health insurance but it can be so expensive. There is an affordable solution if you are laid off or are self employed with a struggling business. Many have chosen short term medical insurance. This immediate inexpensive medical protection provides peace of mind and is affordable coverage until new employment is secured or your business rebounds.

Don't delay and act today to see if this is the right solution for your situation and get a Short Term Health Insurance quote now.
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*New York Times February 6, 2009