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Do IT this week: Layering
Unemployed may have numerous options beyond COBRA, which can eat up the bulk of their monthly jobless benefits
By Cheryl Powell
Beacon Journal medical writer
Published on Monday, Feb 09, 2009
When Robbin Hazlett recently lost her job at a uniform and linen company, the cost to continue her health coverage could have taken her to the cleaners.
To keep the same insurance plan her former employer used to provide, the Barberton woman would have paid nearly $400 a month.
So while she continued to look for a new job, Hazlett also shopped around for a more affordable insurance option.
This month, the healthy 54-year-old signed up for a plan from SummaCare that costs a more manageable $149 a month but carries with it a $10,000 deductible for hospitalizations and some outpatient services.
Her one prescription medicine — a generic drug to prevent osteoporosis — costs her a $10-a-month copay under the plan.
''I don't think people realize you can get cheaper health coverage if you look around,'' Hazlett said.
But not everyone can find coverage they can afford to keep.
As thousands of Americans are losing their jobs with the economy in recession, those pink slips often create a black mark on their financial ability to get health insurance.
Given the economy's impact on family budgets, many find themselves going without health insurance.
A study recently released by the national health-care consumer advocacy group Families USA found more than half of the unemployed Americans who earned less than 200 percent of the federal poverty level in the previous year were uninsured.
For a family of four, that means their annual income was less than $44,100.
In Ohio, more than 115,000 unemployed, lower-income workers are uninsured, the study found.
''It's really risky,'' said Cheryl Fish-Parcham, deputy director of health policy for Families USA. ''I've been getting calls daily from people who had to go without insurance and are in really bad situations right now.''
Dr. Karen Barton, medical director at Akron Community Health Resources, is caring for more and more patients who are losing their jobs and, consequently, their health insurance.
The federally qualified health center has seen its percentage of patients who are uninsured increase from about 33 percent eight months ago to nearly 40 percent today in the Akron office, Barton said. At its new Portage County clinic, about half the patients are uninsured.
''They come to us and say: 'I'm almost out of medication, I've lost my insurance and, as I result, I can't afford my medicine,' '' Barton said.
COBRA help limited
The federal law known as COBRA (the Consolidated Omnibus Budget Reconciliation Act) gives many workers and their families who lose their health benefits the right to continue group health insurance benefits for 18 months in most cases.
But the COBRA protection applies only to workers at companies with 20 or more employees that are still in business.
If the company closes, COBRA isn't an option.
People who work for smaller firms have the right under state law to continue coverage for six months, said Doug Anderson, chief policy officer for the Ohio Department of Insurance. Lawmakers are considering extending eligibility for 12 months.
To keep coverage through COBRA or under the state law, the former employees must pay the total premium.
Last year, the average total for health insurance provided by employers nationwide was $4,704 for single coverage and $12,680 for family coverage, according to the Kaiser Family Foundation, a nonprofit health-care research group. Workers, on average, contributed $721 last year for single coverage and $3,354 for family coverage.
By comparison, most people who sign up for individual family plans from Medical Mutual of Ohio adjust their deductibles and benefits so their monthly premiums average $200 to $250, said George Stadtlander, Medical Mutual's individual and small-group vice president of sales and chief underwriter.
For many families, the COBRA premium would consume the bulk of their monthly unemployment benefit, according to a recent report from Families USA.
In Ohio, the average monthly family COBRA premium last year was $1,030 — or about 78 percent of the average monthly unemployment benefit of $1,327, the advocacy group found.
Federal lawmakers are considering proposals for the government to pick up 65 percent of the cost of continuing health insurance through COBRA for nine or 12 months for people who lose their jobs.
Other options
In the meantime, people who lose their insurance when they lose their job should first determine whether they can switch to another group plan offered through a spouse's or partner's employer, said Fish-Parcham of Families USA.
She also encouraged people to see whether anyone in the family — particularly the children — qualifies for public assistance. The State Children's Health Insurance Program, or SCHIP for short, has higher maximum income levels for children to get coverage.
Veterans can sometimes get medical care through the U.S. Department of Veterans Affairs, she said.
In addition, she said, people who lose their job because of trade policy might be eligible under the Trade Adjustment Assistance Reform Act to have 65 percent of the cost of their insurance paid by the federal government for as many as three years.
People with chronic medical conditions are probably the only ones who should opt for continuing group coverage through COBRA, said Randy Klein, president of the Northeast Ohio chapter of the National Association of Health Underwriters.
The reason: If they try to get insurance on the individual market, they'll probably be denied or charged hefty premiums, he said.
If one member of the family has a medical problem but everyone else is healthy, Klein said, people should consider continuing the COBRA group coverage only for the sick person and putting everyone else on a less expensive individual plan.
Consumers with chronic illnesses that are under control should provide doctors' notes, test results and other documentation about their condition, said Phyllis Cain, SummaCare's director of sales for Medicare and individual products.
SummaCare's underwriters consider this information when determining the monthly premiums, she said.
Never drop health insurance before getting another plan in place, advised Ellen Laden, director of public relations for Golden Rule Insurance Co., United HealthCare's individual insurance company.
Not only does insurance protect people from huge bills in a medical crisis, she said, but ''it also lets consumers pay the lower, negotiated rates that insurers negotiate with doctors and hospitals.''
Klein urged consumers not to be scared off by plans with lower premiums but higher deductibles that must be met before coverage starts.
''You may or may not pay it,'' he said of the deductible. ''And if you haven't, that's money you banked all year long. You might as well save your money.''
Cheryl Powell can be reached at 330-996-3902 or chpowell@thebeaconjournal.com.
When Robbin Hazlett recently lost her job at a uniform and linen company, the cost to continue her health coverage could have taken her to the cleaners.
Get the full article here.
Comments
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Anti-Politically Correct & Anti-GOP, OH
Posted 08:10 AM, 02/09/2009
This is one thing I can say that I'm glad I'm healthy and won't have to worry about this during my new job search.
Posted 08:12 AM, 02/09/2009
I recently opted to go from full-time work to PRN over the winter months. My COBRA was to be $480.00 a month - I found a plan for $280.00 a month with a $2,500.00 yearly deductable. It pays for well visits & testing. (Yearly EKG, bloodwork, etc) & has an optical plan too. ( Eye exam & one pr. of glasses a year ) Doctors visits & prescriptions count toward your deductable, plus you are billed at a discounted rate. No too bad really ...
WADSWORTH, OH
Posted 08:41 AM, 02/09/2009
classof73-wow-thats pretty good! id like to know more about that plan.....outflipme at the funny place-get it?? thanx.
Akron, OH
Posted 08:54 AM, 02/09/2009
I'm an insurance agent and the odd thing is that many times I can find insurance less expensively for people than their group insurance if they are healthy. That is key - stop smoking and lose weight and you'll be AMAZED what it will do for your insurance premiums!! Many times the group insurance might be really expensive because of 1 or 2 sick people... if your employer doesn't pay the bulk of the premium for you, oftentimes you can do better on your own. Here's the rub: If you become very ill you must keep that policy - at whatever cost - because you can become uninsurable and can't shop other policies either temporarily or permanently depending on your conditions. Cancer, heart surgery, certain serious diseases... if you get one of of those, you're uninsurable forever on an individual policy except for the one you're currently on, and it may become unaffordable. An independent insurance broker can explain all of the differences and options available to you.
Posted 10:10 AM, 02/09/2009
amazing, uninsurable in the United States. that is totally unexceptable for anyone that is a citizen & has lived here, especially one's that are employed or have been employeed have paid taxes, social security & medicare. Send your bills to the white house if you loose your job & have to pay high costs of health insurance.
Tallmadge, OH
Posted 10:39 AM, 02/09/2009
UHC solves everyones' problems with health insurance and coverage gaps due to employment loss. Maybe when they get done with the Demo-Pork Stimulus bill if there is any money left, the Dems will do UHC as promised during the election.
Posted 10:44 AM, 02/09/2009
A 48yo/female/nonsmoker can get $126/month, $5000/yr deductible plan through Golden Rule insurance with Rine Agency. (pay your regular doctor visits out of pocket & just be covered for big medical costs)
Posted 11:21 AM, 02/09/2009
BillyBob - I actually found my agent through an add on TV. Check out Medical Mutual of Ohio. They will give you rates on-line & over the phone. BTW ... Considering I am a smoker ... I thought the rates were really good!
Barberton, OH
Posted 11:56 AM, 02/09/2009
Hope it stays that way sp3333. I was healthy as a horse myself last year when suddenly one morning an out-of-the-blue, sharp pain ended up putting me in the emergency room and into the hospital for 5 days and away from work for a week after that. You never know what's going to hit you.
Akron, OH
Posted 12:22 PM, 02/09/2009
The $149/mo. premium and $10 prescription co-pay is surprisingly good, and although the $10,000 deductible is ominous, this is where a Health Insurance Savings Account is a good idea.
Everyone should look into HSA's, because they correspond to a high deductible on one's insurance, and high deductibles make the insured more careful about shopping around for the best price. The HSA fund belongs to the consumer, is tax free, portable, carries over year-to-year, and can be used for almost anything not covered by health insurance.
High deductible reduces costs for everyone, because for one thing, it makes people think twice about going to the ER, the most costly place to deliver care, for minor problems. When the consumer makes the decision about how to use THEIR money in the HSA, wiser, more thrifty decisions are made.
Health insurers and banks offer HSA's. This is from State Farm online and there's much more info available. "You can use your HSA to pay for qualified medical expenses, including insurance deductibles, co-pays and co-insurance, dental and vision care, and even over-the- counter medications. There are some situations where you can use the money to pay for insurance premiums, such as: COBRA premiums, health insurance premiums while receiving unemployment benefits, Medicare premiums and qualified long-term care insurance."
Also, everyone should become well acquainted with the state insurance commission, Ohio Dept. of Insurance. They are the watchdogs over insurers' and agents' practices, over the financial solvency/reliability of companies, and they go to bat for consumers having problems with all types of insurance. Call them in Consumer Services for sound advice. http://www.ohioinsurance.gov/
akron, oh
Posted 12:43 PM, 02/09/2009
My employer offers a plan for nearly $500 a month for a couple! We found a plan through our church denomination and only pay $85 a major medical plan. It only covers ER visits, hospitalizations after a $5000 deductabile, and lab tests over $200. Our doctor offers a discount if you pay cash at a visit, usually $25-$45 a visit. All our drugs are covered under those store $4 a bottle plans. We add currently $100 a month to a HSA if we ever need it. Why pay top dollar for a Cadillac plan we do not need? Have you EVER needed to spend $5000 every year in medical care? Not in most cases for a healthy family. This is where the HSA really comes in handy, gives you a cushion if needed, and you the consumer are in control of your health care costs. Not the government.
Posted 06:20 PM, 02/10/2009
I was glad to see that Robbin looks happy and healthy.
Posted 09:14 AM, 02/27/2009
Yes, I am a bit biased, but an HSA is clearly an option to consider. I have one (Family of 4) and it works quite well. The "re-priced" discounts are generally quite substantial and the tax deductions are a welcomed incentive.
Here in SW Ohio, Anthem and UHC are the best options. Medical Mutual's rates appear to improve the further North in the state you go.
We don't need Universal Health Care. Implementation and partial funding of HSAs would cure the problem in 18 months.
I should know (and here's my shameless plug). I'm the owner of Ohioquotes.com, the premier source for Ohio health insurance.
