HIPAA Law



             


Tuesday, May 20, 2008

Health Insurance ? It's Important To Know What's Not Insured!

Around 7 million people in the UK are covered by health insurance, the majority being covered through their employers. The problem is that few have really studied their policy documents and many misunderstand what is covered. And perhaps just as important, what isn't. If you expect health insurance to pay all your health costs, you're mistaken.

Health insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you'll know what to look out for!

Sorry ? it's a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it's a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic - and no, you won't be covered.

But drawing a firm line between what is acute and what is chronic is fraught with problems, and leads to the biggest area of conflict between insurer and policyholder.

Everyone agrees that diabetes and asthma are chronic conditions as you're likely to suffer from them for the rest of your life. So those sorts of condition are not covered.

Problems arise when the medical team initially considers a patients' illness to be curable, but the condition subsequently deteriorates and the doctors change their mind, it's now become incurable. This can happen especially in the treatment of some types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic - and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry - it's too long term
The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define ?long-term?. You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry ? it's preventative
Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and Standard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry ? the drug is not approved
Two of the main attractions for taking out health insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there's a rider.

Unless the drug has been approved for use by the NHS in England and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute's brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief - and one that has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if a health policy won't pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry ? it's a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition ?pre-exists? the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you injured your knee playing football. It appeared to recover but now it turns out that you have a torn cartilage and need an operation. The insurer could argue that this is a pre-existing condition and you have to pay for its' treatment.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you've suffered from within the last 5 years, then they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry ? its not covered

Health Insurance is an annual contract ? just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it's possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers' pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there's also a trend for new treatments to cost more ? Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So when you are considering Health Insurance, be aware that everything is not always black and white. And if you've got insurance and need treatment, always contact your insurer without delay and get them to confirm that your treatment is indeed covered

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Thursday, May 1, 2008

Travel Health Insurance: Know Your Coverage Before An Emergency Occurs

(NC)Buying travel health insurance is an important step for sufficient medical coverage while outside Canada, but it is only the first step. To make your policy work, say industry regulators, there has to be a co-operative relationship between the policyholder and the company.

Indeed, the range of medical treatment around the world is so broad and varied, home-based insurance companies will provide booklets outlining what they will, and will not cover. Therefore, an equally important step at the time of purchase is for the traveller to become as familiar as possible with the basic guidelines of the policy before an emergency occurs. Decisions on the reimbursement of expenses are not likely to be the first thing on your mind in an urgent situation.

So how do we ensure financial coverage during a medical emergency? Here are a few guidelines offered by the Financial Services Commission of Ontario (FSCO). FSCO is an agency of the Ministry of Finance that regulates Ontario's insurance industry.

Obtain authorization

As soon as possible, says FSCO, call the emergency service centre telephone number provided with your policy. The service centre's role is to manage your medical care and make the claim process fast and efficient. The centre provides claim administrators, on site doctors, nurses and other medical professionals to arrange care and monitor treatment. To ensure coverage, if possible, don't proceed with any medical treatment without full authorization.

You can assist the claims process more efficiently, if you:

Supply all the facts and information accurately.

Keep a log of the contacts at both the service centre and your insurance company, including the names of people assisting you, the date of the contact, and what was discussed.

Keep a detailed record of all medical transactions. Get receipts for the medical care including tests, treatments, and prescriptions. Receipts are a must when making a claim. Also, observe the time limits of your policy.

Complete the forms supplied and enclose all original bills signed by the attending physician, plus receipts and supporting claim documentation. Be sure to include your policy identification number, health card number and date of birth. Keep copies of all documentation submitted to the company.

More information on travel health insurance is available online at www.fsco.gov.on.ca. Or, for a copy of their booklet Shopping for Travel Health Insurance phone (416) 590-7298 (Toll Free: 1-800-668-0128).

- News Canada

News Canada provides a wide selection of current, ready-to-use copyright free news stories and ideas for Television, Print, Radio, and the Web.

News Canada is a niche service in public relations, offering access to print, radio, television, and now the Internet media, with ready-to-use, editorial "fill" items. Monitoring and analysis are two more of our primary services. The service supplies access to the national media for marketers in the private, the public, and the not-for-profit sectors. Your corporate and product news, consumer tips and information are packaged in a variety of ready-to-use formats and are made available to every Canadian media organization including weekly and daily newspapers, cable and commercial television stations, radio stations, as well as the Web sites Canadians visit most often. Visit News Canada and learn more about the NC services.

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Tuesday, March 11, 2008

Tales from the Corporate Frontline: The Worth of Health Insurance

This article relates to the Compensation and Benefits Competency, commonly evaluated in employee satisfaction surveys. The questions included in this competency will help your organization determine whether your employees feel they are fairly paid for the work they perform when compared to a similar job at a different company. This competency also queries their feelings regarding the adequacy and quality of their benefits package. A fair and attractive compensation package is critical for hiring and retaining quality employees. A high satisfaction level in this competency requires that your compensation structure and benefits package be fair, balanced, and understood by your present employees.

This article relates to the Compensation and Benefits Competency, commonly evaluated in employee satisfaction surveys. The questions included in this competency will help your organization determine whether your employees feel they are fairly paid for the work they perform when compared to a similar job at a different company. This competency also queries their feelings regarding the adequacy and quality of their benefits package. A fair and attractive compensation package is critical for hiring and retaining quality employees. A high satisfaction level in this competency requires that your compensation structure and benefits package be fair, balanced, and understood by your present employees.

This article, The Worth of Health Insurance, is part of AlphaMeasure's compilation, Tales from the Corporate Frontlines. It focuses specifically on the value of employer provided health insurance to employees in today's workplace and economic climate.

Anonymous Submission:

Large salary increases are rare these days, especially for mid level, mid career employees. Having worked at the same small, family owned business for about ten years now, my fellow employees and I were accustomed to getting about the same raise every year. It never varied very much, and we considered it fair, especially since the business was quite solid and successful with a steady profit stream for the past several years.

That's why we were all so shocked this year when our expected increase amount was cut in half. After the shock faded, the office was abuzz with speculation "the company is going under, that sales rep, Mr. Brown, lost that lucrative account, I knew this would happen, the owners are just getting greedy, they're thinking of selling to a large multinational" - were some of the stories considered.

Finally, our general manager caught wind of the discussions and settled us down for a meeting. He told us that the reason the increases had been cut was that the health insurance program premiums had risen very sharply. The owners decided that rather than require the employees to pay more for the insurance, it would be better to pay the extra premium and give smaller salary increases. He told us that many companies are handling rising premiums in much the same way.

Many employees, myself included, were skeptical. Sure, we told each other. That's a good story. And we picked up where we'd left off with our previous speculations.

That night, I received a phone call. It was my sister, and she was crying. She's a stay- at- home mom, her husband has been downsized, and the family is at the point where it has to pay for health insurance. As my sister tearfully recited the rates she'd been quoted, I was beyond shock. It amounted to a small fortune. After she hung up, I went online to my health insurance provider website. I checked the rate I would pay without my employer contribution. The price difference was far higher than my raise reduction, and the coverage wasn't as good.

Humbled, I went to work the next day and told my coworkers what I'd discovered. We'd all underestimated the worth of a solid benefit plan with good health insurance in today's workplace and economy. Suddenly our salary increase seemed a lot larger.

AlphaMeasure Employee Surveys, Inc. -
This article may be reprinted, provided it is published in its entirety, includes the author bio information, and all links remain active.

Measure. Report. Improve your organization with AlphaMeasure employee surveys.
Josh Greenberg is President of AlphaMeasure, Inc.
AlphaMeasure provides organizations of all sizes a powerful web based method for measuring employee satisfaction, determining employee engagement, and increasing employee retention.

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Thursday, February 28, 2008

Is Pet Health Insurance an Option?

Most pet owners arent aware that health insurance for their loved animals has been available for about 15 years now. However, both the availability and restrictions on most plans have made this type of health insurance out of reach for most pet owners.

Interestingly enough, pet health insurance has changed in the past couple of years. Now, animal owners are able to afford medical procedures previously prohibitive because of the cost. But many skeptics are concerned that health insurance for pets will see an increase in the red tape us humans already encounter every day.

Animal medicine is one of the few health care services that isnt financially dependent on health insurance. Medical, dental, surgical and pharmaceuticals are all pretty much covered by health insurance in humans, but veterinary patients are responsible for all of that, themselves. Or, at least their owners are.

Health insurance for pets is very similar to insurance for humans. The same fees, deductibles, coverage rates and plans are all in place, with different plans based on the age, species, and general health of your pet.

Most health insurance policies for animals start around the 6-8 week range, but when the policies end depend on a variety of factors, mostly decided by the health insurance company. Some have age limits, and some dont.

And just like with humans, some health insurance companies will only accept your pet on their plan if they are healthy; others will accept them only if they have had a stable condition for more than six months in a row.

Currently, deductibles stand around $100 for pet health insurance. Policy costs vary as much as human health insurance does, unfortunately. Some depend on what types and kind of coverage is desired, and yet others are just blanket coverage catch-alls. Some may only cover accidents and illnesses. And more pets usually means a reduced health insurance rate for subsequent animals.

But what if you decide that an health insurance policy is not right for you, and your pet? There are other options, of course!

First, discuss your situation with your Veterinarian. Some animal hospitals offer packages that arent quite health insurance, but can offer a rate deal of some sorts on more mundane medical procedures (spaying/neutering, vaccinations, etc.), or packages for your aging animal.

Secondly, research plans that offer discounts on animal health services. PetAssure is one of these companies, but there are a myriad of not-for-profits that may offer this as a side benefit when you join. Or, these same animal not-for-profits may offer financial assistance for pet owners whose health costs are beyond their means a sort of emergency fund, if you will.

All in all, it depends on you, and your pet(s), whether or not pet health insurance is the right choice. Hopefully, with the help of this article, your choice will be an informed one.

For more more information about pet health insurance please visit http://www.1health-center.com/articles/The-Important-of-Health-Insurance.php

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Thursday, January 31, 2008

HIPAA Compliance In A Technical World

The way people do business today relies more and more on internet connections and ?virtual? phone lines. This presents a problem for those in the medical industry and those required by the Department of Health and Human Services to follow the guidelines of The Health Insurance Portability and Accountability Act of 1996 (HIPAA). Those companies that deal with Personal Health Information (PHI) want to make sure that they are able to keep up with technology, and all the convenience and efficiency that it has to offer, yet at the same time ensure that the technology does not put their clients? confidential information at risk. One such technology that those in the medical industry are finding numerous benefits to is virtual fax.

The benefits of virtual fax can be summed up in one word: efficiency. With a virtual fax there is no longer any need to go back and forth from the fax machine for sending or receiving faxes. All faxes can come into an email address or internet control panel and faxes can be sent right from the desktop as well. Since the faxes are digital, it is possible to clean up any paper trail and keep a digital file of all important correspondence. Another added benefit is the ability to rid the office of the bulky fax machine with all of the maintenance and upkeep that goes along with it. While it is easy to see how any office can benefit from the use of virtual fax, it may not be as obvious as to how they can do so and still stay HIPAA compliant.

There are four categories of security requirements under HIPAA and it is the consumer?s responsibility, according to the HIPAA regulations, to examine the technology employed by a virtual fax provider and determine how to use it in a compliant manner. Here are some things to look for in a virtual fax provider that help medical providers maintain compliance.

1.Administrative Procedures ? A virtual fax provider should have documented, formal practices to protect data and limit access to files. Most virtual fax providers will have policies that allow access to fax messages for the purpose of maintenance, customer service, repair, and backup, or in response to legal inquiries or warrants that legally force the disclosure of the messages or documents from courts or government agencies.

2.Physical Safeguards ? A virtual fax provider should be able to protect data from fire, other natural and environmental hazards and intrusion. A provider should have measures in place that include an industry standard fire safety system, off-site backups, and industry standard security systems to protect Personal Health Information from physical vulnerabilities.

3.Technical Security Services ? a virtual fax provider should have measures in place to protect information and control individual access to information. There are usually 3 ways to access documents in a virtual fax system and each one should have their own independent security measures.

?Access to a virtual fax system by phone should be restricted with PIN access.
?Email delivery of virtual fax messages should be sent using encryption technology. An added security feature is the ability to have the email delivery of fax documents configured for a ZIP format with password/encryption.
?Virtual fax access over the internet should also be PIN protected as well as be secured by industry standard protocols and encryption algorithms. An added security feature would be that the internet portal?s identity be verified by an SSL certificate.

4.Technical Security Mechanisms ? A virtual fax provider should be able to guard against unauthorized access or loss of data over the communications network. Data storage systems should implement industry standard fault tolerant measures to prevent data loss due to storage media failure. Databases and storage systems should be protected by battery backup technology to protect against potential data loss due to power failures. In addition, servers should use a measure comparable to FreeBSD UNIX to prevent unauthorized access and data security compromise.

For a medical provider in a technical world it can be difficult to keep up with all the current technology and still be sure to follow all the guidelines they are subject to. While ultimately it is the consumer?s responsibility to determine whether or not a virtual fax provider allows them to maintain HIPAA compliance, many providers already have security measures in place that can help them stay within the guidelines they are subject to.
Brandi Cummings, an expert in the field of virtual telecommunications, recommends checking out http://www.Fax800.com, a leading provider of internet fax technology for small businesses.

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Wednesday, January 23, 2008

HIPAA legislation guide

The Health Insurance Portability and Accountability Act or HIPAA, which was enacted by the US Congress in 1996, has introduced to sweeping changes in health care administration and information systems. HIPAA is a federal law that has been amended to the Internal Revenue Code of 1986 which intends to improve portability and continuity of health insurance; combat waste, fraud and abuse in health insurance and health care delivery; promote the use of medical savings accounts and improve access to long-term health care services and coverage; and simplify the administration of health insurance.

HIPAA is designed to standardize the way all health care organizations electronically exchange sensitive patient data and to protect patients from unauthorized disclosure of their medical records (whether paper or electronic). Under HIPAA, there are specific standards that all health care organizations are required to adhere to. These standards include an Administrative Simplification Title that is aimed at preventing health care fraud and abuse. Within this title, there are several laws and proposed standards including Electronic Health Transactions Standards, Privacy & Confidentiality Standards, Unique Health Identifiers, and Security & Electronic Signature Standards.

These HIPAA laws and standards directly apply to the following groups of health care entities: health plans, public and private payers, health care insurers, HMOs, Medicare, Medicaid, group health plans, health care clearinghouses, any entity that facilitates the processing of non-standard formatted health information and must convert the non-standard data into standard transactions, or vice versa, Health Care Providers, providers who transmit health information electronically, providers who receive individual health information, and providers who electronically maintain health information used in electronic transmissions between entities.

Non-compliance with HIPAA regulations may cause disruptions in an organization's day-to-day business processes, resulting in both tangible and intangible costs. The most serious implications of HIPAA non-compliance for health care organizations include the inability to effectively conduct electronic business and the potential of losing significant segments of business. The government also imposes some sanctions on those who fail to comply with the regulations of HIPAA. The penalty for failure to comply with regulations goes up to $100 per violation per person up to a maximum of $25,000 per year. Penalty for knowingly and wrongfully disclosing individually identifiable health information is up to $50,000 per violation or one year imprisonment or both for simple offense; up to $100,000 per violation or five years imprisonment or both if the offense is "under false pretenses"; and up to $250,000 or ten years imprisonment or both if committed with intent to sell, transfer or use for commercial advantage, personal gain or malicious harm.

Thus, the ultimate objective of HIPAA is to increase the efficiency and effectiveness of health information systems through improvements in electronic health care transactions as well as to maintain the security and privacy of individually identifiable health information. It helps to promote the modernization of health information systems. Becoming HIPAA-compliant is a challenging task because of extensive cross-departmental compliance and training requirements but it is an ongoing administration, privacy and security challenge that must be constantly addressed.

Mansi gupta recommends that you visit HIPAA legislation for more information

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Thursday, November 29, 2007

Health Insurance; COBRA; OBRA; HIPAA; Medicare; Definitions, Relationships

Health Insurance; COBRA; OBRA; HIPAA; Medicare. If asked, could you state that you knew that all 5 of these topics had the same thing in common: medical insurance coverage for you and, perhaps, your family? Would you know the qualifications for each? Well, in this article, we will discuss them. For a timeline that depicts, graphically, the time relationship between them, please see the timeline in www.disabilitykey.com.

HEALTH INSURANCE Coverage from Work

If we are lucky, we, and/or our spouse, work for a company that provides, as a benefit, health insurance coverage for us and our family. If so, we are very lucky. Even if that is true, there are some key things that you might want to look at to see if you have ENOUGH coverage.

1) From your Human Resources Department (or wherever else you would go to get information about your health insurance) get what is called a "Summary Plan Description" (SPD). This document should be kept where you can always find it, as it contains all the information you will need about what your insurance covers and what it doesn't.

2) Look up "Coverage" and "non-coverage" in your SPD.

These will tell you what your plan covers and doesn't cover. You need to see if, perhaps, you or one of the covered members of your family has a condition or circumstance that might not be covered, where you need additional coverage. For example, let's say that your family has a history of cancer; perhaps your plan restricts the number of hospitalization days for care; or, restricts the days per condition. In this case, (like my children) you might want to get additional "cancer insurance" (I think that AFLAC might provide this type of coverage).

It would be a good idea to contact a Health Insurance benefit Broker and ask him/her to read your SPD and see if you have any gaps in coverage. They then can help you supplement coverage BEFORE YOU NEED IT!

NO HEALTH INSURANCE COVERAGE

You might be one of the growing members of our society that, through one circumstance or another, does NOT have health insurance coverage for your family. In this case, I strongly encourage you to contact a Health Insurance Broker and get immediate coverage of what is called "catestrophic" (not sure if I spelled this correctly) coverage. In this type of coverage, you will generally have large deductibles, but will have coverage if, say, one of you has to go into the hospital.

CONTACTING A BENEFITS INSURANCE BROKER

Whenever you call or email a Health Insurance Broker, it is very important to prepare ahead of time. WHAT, specifically are you looking for; how much can you afford to pay every month; what circumstances do you want to make sure that your family is covered for. In this way, you can make sure to focus on your critical needs.

COBRA

COBRA is an acronym ( how can I spell acronym correctly, yet not be sure that I spelled catestrophic correctly?) that stands for: Consolidated Omnibus Budget Reconciliation Act. Basically, it is a federal law that allows you to pay for your Company-paid health insurance, as an active member, if you no longer work for that company for, generally 18 additional months.

1) COBRA is "triggered" (that is, you, or a covered member of your family, become eligible for COBRA) by events such as the following: resignation from the company; termination (FOR ANY REASON) from the company; divorce of a spouse; a covered chile's birthday makes them ineligible for coverage. These are the main "triggering" events for COBRA.

2) Now, when eligible for COBRA, you will be asked to pay for 100% to 105% of the company's employee/employee and family coverage amount. You should get a letter from your company explaining what that amount will be. BEFORE YOU DECIDE TO TAKE COBRA, there are some important things for you to consider.

What will be your cost, and what will be the coverage for that cost? Sometimes the cost is too much for the coverage. In these cases, you might want to select HIPAA coverage, instead (see HIPAA below).

Or, you might just want to get catestrophic coverage as was mentioned earlier, and wait for full coverage under your next job.

Part of this decision should be whether or not you or a member of your family has what is called a "pre-exisitng coverage" condition.

Here again, before automatically taking COBRA, it would be wise to contact a Benefits Insurance Broker and give him/her all of your options, and get their input. I have worked extensively with a Benefits Insurance Broker, and he is absolutely fantastic!

OBRA

What, you ask, is OBRA? I've never heard of it, you say, and no one I know has heard of it either! Well, that's because, 99% of Human Resource or Benefit folks that I know have never heard of it! OBRA is a federal law that was passed that extends COBRA for an additional 11 months FOR DISABILITY PURPOSES ONLY!! Why, you ask, is this important? Thanks for asking, let's see if I can explain.

If you are as nieve (did I spell this wrong too? sorry!) as I was when I first started looking to bridge my health insurance from working to Medicare, I assumed that when I got through all of the hoops to qualify for SSDI (Social Security Disabililty Insurance) I'd IMMEDIATELY be eligible for Medicare, RIGHT??? WRONG!!!!

When you FINALLY qualify for SSDI, you have to wait for 5 months before you get your first check. AND, the rules state that, you are eligible for Medicare 2 years (24 months) FROM THE DATE OF YOUR FIRST SSDI PAYMENT. Well, if you add 24 + 5 you get, 29 months between qualifying for SSDI, and Medicare coverage.

OK, I said earlier that COBRA is for 18 months of coverage. Well guess what 18 months of COBRA + 11 months of OBRA equal - 29 months!

BUT, there are two catches to OBRA; first of all, you have a small window of 30 - 60 days to apply ( this window opens the date of your SSDI approval); and, it can cost up to 150% of your plan coverage amount. BUT, if you have a "previously existing condition" this might be the best way for you to proceed.

Again, it is important to contact a Health Insurance Broker to help you with the risk/cost ratio of all of these situations.

It is also improtant to know all of these deadlines as you plan to ensure that you and your family have important health insurance coverage.

HIPAA

HIPAA is a federal law that is called, briefly, the "portability" law for health insurance. What that means is that when you leave a group (read company-paid plan), the carrier that provided that plan, must offer to you, another plan, different from COBRA, when you leave the group coverage. Generally this will be what is called a "bare bones" plan. Again, the best thing for you to do is to call/email a Health Insurance/Benefits Broker with all of your information: SPD, COBRA info, HIPAA info, needs, cost limits, and let him/her help you find the optimum plan coverage for you.

MEDICARE

OK, now, finally, we've reached Medicare! BUT (you really didn't think it would be that easy, did you?) if you have qualified for Medicare because of disability, there are RESTRICTIONS (of COURSE there are!).

First of all, if you are qualifying for Medicare because of disability, you are probably under the age of 65 - normal retirement age.

Medicare coverage does NOT cover prescription drugs, which, those of us with disabilities probably need, and which cost lots.

But, Congress prescribed that states (all but 11) offer what is called "Medicare supplement" plans, some of which do offer prescription coverages. BUT, these plans ARE NOT REQUIRED TO, and do not, offer these medicare supplement plans that offer prescription coverages to folks who qualify under age 65! So, if you are qualifying because of disability, your medical insurance plan doesn't cover one of your primary cost expenditures!

Here again is where you need to contact a health insurance/benefit broker. Again, he/she can work with you, and your specific circumstances, to get you the coverage you need.

Hope that this information was helpful to you. If you have any questions, please feel to ask them by commenting on this blog, and I'll be happy to get you an answer.

About Disabilitykey.com & Carolyn Magura:

Disabilitykey.com is a website designed to assist each person in his/her own unique quest to navigate through the difficult and often conflicting and misleading information about coping with disabilities.

Carolyn Magura, noted disability / ADA expert, has written an e-Book documenting the process that allowed her to:

a) continue to work and receive her “full salary” while on Long Term Disability; and

b) become the first person in her State to qualify for Social Security Disability the FIRST TIME, in UNDER 30 DAYS.

Click here to receive Carolyn 's easy-to-read, easy-to-follow direct guide through this difficult, trying process. If you are disabled, don't let this disabiling process

 disable you. Read Carolyns Disability Key Blog.

 

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