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Insurance depends on circumstances

Published on Tuesday, Jun 24, 2008

 

The remedy to health insurance coverage depends on your individual situation:
If you recently lost your job, had health insurance at that job, and your former employer had at least 20 workers:

Under a federal law called COBRA, you have the right to stay in the health plan you had at that job for up to 18 months, as do family members who were covered as your dependents.

However, you must pay the total premium — your cost plus the employer's cost — which can be very expensive.

And you must act quickly. You must sign up for COBRA within 60 days of losing your job.

For more information about COBRA, visit the U.S. Department of Labor's ''Frequently Asked Questions about COBRA Continuation Coverage'' on the agency's Web site at http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html or call 866-275-7922. If you recently lost your job, had health insurance at that job, but your former employer had fewer than 20 workers:

Under Ohio law, former workers of small businesses and their covered dependents might have a right to pay for continuation coverage for six months.

For more information about your rights to continued coverage in Ohio, contact the Ohio Department of Insurance at 800-686-1526 or http://www.ohioinsurance.gov. If you recently graduated from school, divorced, lost a spouse or experienced a life change that caused you to lose coverage under a spouse or parent's job-based health plan:

When a person loses dependent status, COBRA can continue coverage for up to 36 months. Again, though, you must act within 60 days of being notified by the health plan. And you'll have to pay the full premium.

If the employer had fewer than 20 workers, though, Ohio law does not guarantee you the right to pay for continued coverage.
If you recently lost your job because of trade policy:

The federal Trade Adjustment Assistance Reform Act can pay 65 percent of the cost of your health insurance for one year, and sometimes longer. You might qualify for this help, for example, if your employer laid off workers because the company's products are being replaced by products from other countries or because the company is using more workers in other countries.

For more information, contact the Health Coverage Tax Credit (HCTC) Customer Contact Center at http://www.irs.gov/individuals/index.html or 866-628-HCTC. If you are an early retiree who has lost your health coverage:

Retirees 55 or older can receive help with 65 percent of health insurance costs until you are eligible for Medicare, if your former employer no longer provides your pension and your pension benefit is paid by the federal Pension Benefit Guaranty Corp.

For more information, contact the Health Coverage Tax Credit (HCTC) Customer Contact Center at http://www.irs.gov/individuals/index.html or 866-628-HCTC.
If you can't afford health care or insurance:

In Ohio, check with Medicaid/Healthy Families and Healthy Start to see if you or your family meet income and asset limits.

Generally, you can get coverage if you are pregnant, a parent with a child living at home, a person with a disability or a person who spends most of your income on health care.

Children can often get coverage — even if their parents don't qualify — because the income limits are usually higher for children.

For more information on Medicaid/Healthy Families, call 800-324-8680. For more information about children's health-care coverage, call 877-KIDS-NOW or visit http://www.insurekidsnow.gov. If you're shopping for a health insurance policy in the private market, here are some questions to keep in mind:

What medical services are covered?

How much must I pay for a deductible before the insurance starts to help pay for services?

After I reach my deductible, how much do I pay for services, and how much does the insurance company pay?

Does the policy limit the total I have to spend out-of-pocket for covered services in a year? (Check the maximum carefully; sometimes not all spending counts toward it.)

Does the plan cover health problems I already have? If it does not cover these problems right away, when would it begin covering them?

Are the doctors I want to see covered in this policy? If not, would I have to pay extra to see any of my doctors who are not in the network? (Check with your doctors directly to see if they would accept this insurance for your care.)

Also, be careful about plans that don't offer insurance coverage but offer only discounts on the cost of health-care services. Generally, these plans are not a good buy, and many insurance regulators warn against buying them.

Check with the Ohio Department of Insurance (800-686-1526) to make sure the insurance company you're considering is licensed in Ohio and if there have been complaints about the company.

Source: The Robert Wood Johnson Foundation's
Cover the Uninsured project

 

Get the full article here.


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