Insurance For The Self Employed And Those Seeking Health Insurance

First of all, congratulations on deciding to go out and make it on your own. The rewards and excitement of making it on your own can not be found anywhere else. Now, when looking for insurance for the self employed for a person like yourself, it's important to remember that generally you'll find better rates if you deal directly with the insuring company. There are many confusing options available but the good news is that there are quite a number of affordable health-insurance programs out there, and navigating the maze of available policies is easier than ever with the help of the Internet. The internet now allows individuals the chance to plug in a few personal details and obtain information on insurance for the self employed. Some questions to consider when choosing your coverage are the following:

1) Is it important that you keep your current Doctor?

2) Is it important that you have access to alternative care such acupuncture or massage therapy?

3) How high a deductible are you comfortable with?

Insurance for the Self Employed tailored to your needs.

Most people looking for insurance for the self employed are seeking modest insurance coverage, but they also want some of the basic essentials such as regular Doctor visits and prescription coverage. Keep in mind that your premium costs will vary depending on how high your deductible is and what kind of coverage you have. Generally the higher the deductible, the lower your monthly premiums. When choosing your coverage try to match low prices with quality coverage. Don't let the lure of having no insurance coverage persuade you that health insurance, even if you're seeking insurance for the self employed, is not something you need. That simply isn't the case. The cost of a major hospital visit can vastly exceed any premiums you may not have paid over the past several years.

Mike Yeager

http://www.a1-healthinsurance-4u.com/

mjy610@hotmail.com

Health Insurance for International Travelers

If you are planning a trip overseas then you have probably wondered how your US medical plan will cover you outside of the U.S.

If you have a managed care (HMO) plan, then you might not have any coverage outside of the US. Any coverage you do have with an HMO is likely to be significantly reduced when you travel, with greater out-of-pocket expense for treatment outside of your normal coverage area.

Privately issued medical insurance usually does cover you during overseas travel, but the cost of obtaining records, translating them into the English language, converting the currency, and delivering payment overseas is all your responsibility, not the insurers.

One easy option is to have a short term medical policy specifically designed to cover international travelers to supplement your primary coverage. Fortunately these are inexpensive and easy to obtain. Since these plans specialize in international travel, there are fewer hassles typically associated with health plans. The coverage can usually be issued in about two days with a confirmation sent by fax or e-mail to your travel destination if necessary.

See the FAQs at www.medsave.com for more details.

If you have a managed care (HMO) plan, then you might not have any coverage outside of the US. Any coverage you do have with an HMO is likely to be significantly reduced when you travel, with greater out-of-pocket expense for treatment outside of your normal coverage area.

Privately issued medical insurance usually does cover you during overseas travel, but the cost of obtaining records, translating them into the English language, converting the currency, and delivering payment overseas is all your responsibility, not the insurers.

One easy option is to have a short term medical policy specifically designed to cover international travelers to supplement your primary coverage. Fortunately these are inexpensive and easy to obtain. Since these plans specialize in international travel, there are fewer hassles typically associated with health plans. The coverage can usually be issued in about two days with a confirmation sent by fax or e-mail to your travel destination if necessary.

See the FAQs at www.medsave.com for more details.

Tony Novak, MBA, MT is a writer and financial adviser in Narberth, PA focusing on tax and employee benefit issues. His businesses www.MedSave.com and Freedom Benefits Association provide online benefits enrollment for thousands of individuals and businesses nationwide.

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.

Health Insurance for the Self-Employed - Protecting Your Business's Greatest Asset

Health Insurance for the Self-Employed - Protecting Your Business's Greatest Asset

2002 Elena Fawkner

"I've been considering quitting my full-time job and getting a part-time job that would pay the bills [so I can start a home business] ... The one biggie my full-time job provides me now is health insurance. If I was to get a part-time job, I'd probably have to pay for my own health insurance and I know that can be expensive."

Like Jason, who sent me the above email this week, many a dissatisfied employee would chuck in their full-time J.O.B. (just over broke) for their part-time home-based business in a heartbeat if not for one thing. Employer-provided health benefits. It's a biggie, no doubt about it.

Undeniably, employer-paid or -subsidized health benefits are one of the few real perks of working for someone else. In fact, surveys have shown that, for employees (especially those with families), paid benefits are hands down the most important element of their compensation packages.

And there's no shortage of people already running their own home businesses with no health or disability coverage at all. Scary. After all, if you're dependent upon your home business as your sole source of income and you lose your health, you lose your livelihood as well.

Bottom line? If you run a home-based business you can't afford not to have health coverage of one form or another. Here's how to make it happen, whatever your circumstances.

BASIC OPTIONS FOR THE EMPLOYER OF ONE (YOU)

You have three basic options when it comes to health and disability insurance.

=> Spouse Coverage

If your spouse has health coverage from his or her employer, as a general rule, use that. It probably provides better and less expensive coverage than you could get on your own.

=> Group Health Insurance

The main advantage of group health insurance plans is that they can't turn you away because of health problems. The good news for the solo entrepreneur is that an increasing number of companies are offering group health plans for "groups" of one. This varies by state though so you'll need to do your homework to find one.

=> Individual Health Insurance

These plans are fine if you don't have any pre-existing medical conditions. (If you do, try your best to find a group plan that will cover a group of one.) They're subject to medical underwriting so your state of health will be a factor the insurance company takes into account in determining whether to accept your application.

Of course, the mere fact that you're able to get into a good plan is one thing. Doing so affordably is quite another.

REDUCING THE HIGH COST OF HEALTH INSURANCE

There are several ways of minimizing the cost of health insurance. Your tolerance for risk will determine which, if any, you are comfortable with.

=> Reduce the Level of Coverage

Do you really need to have every doctor's visit and prescription covered? If you only go to the doctor once a year for an annual examination, have no health conditions, don't need regular expensive prescription medications and are generally healthy, consider cutting out coverage for office visits and prescriptions.

=> Higher Deductible

Similarly, if you're reasonably healthy, don't visit the doctor very often and don't need to use expensive medications, consider switching to a higher deductible to save on premium costs. By increasing your deductible from $100 to $2,000, you can cut your premium payment in half.

=> Annual Premium Payments

If you can afford to do so, pay your premiums annually rather than monthly or quarterly to avoid service fees and to take advantage of prepayment discounts where available.

=> Join Associations

Just because you're going it alone in your business doesn't mean you can't take advantage of the group buying power that being a member of an association offers. Check out your local chamber of commerce, various trade and professional groups and small and home business associations for member benefits. Many offer access to discounted health insurance.

Here are a few small/home business association links to get you started (you'll need to cut and paste some of these links if they wrap to the next line):

National Association for the Self-Employed http://www.nase.org/nase_benefits/health_benefits.asp American Association of Home-Based Businesses http://www.aahbb.org/benefits.htm Home Office Association of America http://www.hoaa.com/allbenefitsnew.htm National Business Association http://www.nationalbusiness.org/NBAWEB/Directory/Internal_Pages/Member_Benefits/Health.htm

Don't forget to check out local associations in your area or associations relevant to your particular profession.

=> Shop Online

Being able to offer insurance products online means insurance companies save on broker and agent fees. Often, this translates into premium savings for policies purchased over the Internet. So, when your fingers do the walking, make sure they do so on a keyboard and not the Yellow Pages.

=> Medical Savings Accounts

Under the Health Insurance Portability and Accountability Act (HIPAA), if you're self-employed you may be eligible to use a medical savings account, or MSA.

MSAs work in conjunction with higher deductible health insurance policies to reduce premiums and allow you to use pre-tax dollars to pay for your medical expenses up to the limit of the deductible on your insurance policy.

Basically, you reduce your premium by replacing a low- deductible policy with high-deductible policy and use the premium saving to make fully tax-deductible contributions to your MSA. You can contribute up to 65% of the deductible each year into your MSA (75% for families). The money goes into a tax-deferred account or trust and you pay your medical expenses (until you reach the deductible) by drawing from the account. Once you hit the deductible, of course, the insurance policy kicks in.

If you spend less than you contributed, the surplus stays in the account and earns interest. Not only that, the funds can be invested in high-return vehicles such as mutual funds and stocks.

As the balance can be carried forward, an MSA can be used to accumulate a pretty healthy nest egg for retirement. In fact, a Journal of Financial Planning analysis calculated that if you contribute $1,500 per year into an MSA for 25 years, assuming a 12% rate of return, you'll end up with almost $1.5 million. That's assuming you don't draw from it to pay for medical costs, of course.

There are some limitations though. First, the range of deductibles is limited to $1,500 - $2,250 for individuals and $3,000 - $4,500 for a family. Second, as we saw above, you can contribute only 65% of the deductible as an individual or 75% for a family.

So, if you're an individual and you choose a policy with a $2,000 deductible, you'll be able to contribute 1,300 pre-tax dollars into an MSA each year. In other words, Uncle Sam pays for part of your health insurance/retirement fund. How fitting.

The money in the MSA can be used to pay any medical expenses incurred before the deductible is reached, as well as other eligible costs such as contact lenses and dental work. If you use the money for anything else, you must not only pay tax on the amount withdrawn, but a 15% penalty on the top. (If you're over 65 when you make the withdrawal the penalty is not applied but you'll still have to pay the tax.)

(By the way, MSAs are also available to you if you work for a business with fewer than 50 employees.)

In short then, MSAs offer a very tax-effective and potentially lucrative way to self-fund part of your health care costs while dramatically reducing your premiums. If luck is on your side and you remain healthy, by the time you reach retirement age, your MSA could well fund your retirement.

Pretty neat.

=> Self-Employed Health Insurance Deduction

Finally, the self-employed can write off 70% of their health insurance premiums in 2002. This increases to 100% in 2003. That's only so long as the total doesn't exceed the net profit from your Schedule C minus deductions for one half of the self- employment tax and Keogh, SEP and Simple contributions though.

Also, the deduction can only be claimed for months when you weren't eligible to participate in a subsidized health plan from another employer (including your spouse's employer).

Self-employed workers who qualify for both the self-employed health deduction and the itemized medical deduction can write off the other 30% this year on Schedule A. (Medical expenses are deductible on Schedule A only to the extent they exceed 7.5% of adjusted gross income.)

WHAT TO DO IF YOU'RE UNINSURABLE

The foregoing is all well and good if you're able to get health insurance in the first place. But what if you have a pre- existing condition that disqualifies you from an individual health plan and you can't get into a group plan? In other words, you can't get insurance at any price.

=> HIPAA

Although beyond the scope of this article, the Health Insurance Portability and Accountability Act (HIPAA) may offer you some protections. For more information about how HIPAA may help you obtain health insurance even if you have a pre-existing condition, visit http://www.hcfa.gov/medicaid/hipaa/content/hipsteps.asp .

=> Risk Pools

High-risk health insurance plans, also known as risk pools, are state-funded plans and are an important safety net for individuals who are denied health insurance because of a medical condition. They're available only in 29 states though.

To be eligible, you must be a resident of the state from which you seek coverage (unless there's reciprocity between that state and the state you reside in) and you must be able to prove at least one of the following:

1. that you've been rejected for similar health insurance coverage by at least one insurer; or

2. you're presently insured with a higher premium; or

3. you're presently insured with a rider or rated policy.

You will not be eligible for participation in a risk pool if:

1. you're not a resident of the state from which you seek coverage (again subject to reciprocity between states); or

2. you're eligible for Medicare or Medicaid; or

3. you've terminated previous coverage in the plan unless at least 132 months have since elapsed; or

4. you're an inmate of a public institution.

For more information on risk pools in your state, contact your state health insurance department, the national association "Communicating for Agriculture and the Self- Employed" (1-800-432-3276) or visit http://www.selfemployedcountry.org .

Coverage via the safety-net protections of the HIPAA may end up being "risk-pool" coverage.

=> Healthcare Savings Programs

Healthcare savings programs are patient advocacy programs that minimize out-of-pocket healthcare expenses.

They're not insurance policies but rather programs that allow you to access networks of healthcare providers for the same negotiated rates that large insurance companies enjoy. Savings range from 20% to 50%.

Not ideal but better than nothing. Also, since they're not insurance policies, all pre-existing conditions are accepted.

A modest monthly fee is usually required to participate. See, for example, Care Entree at http://www.careentree.com for $20 per month.

Although health insurance may seem like a luxury you just can't afford if your finances are already stretched to breaking point thanks to your home-based business, you never know what's around the corner. Quite simply, you and your business can't afford not to have health (and disability) insurance.

You are your business's greatest asset. Protect it.

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** Reprinting of this article is welcome! ** This article may be freely reproduced provided that: (1) you include the following resource box; and (2) you only mail to a 100% opt-in list.
Here's the resource box to use if reprinting this article:

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Elena Fawkner is editor of A Home-Based Business Online ... practical business ideas, opportunities and solutions for the work-from-home entrepreneur. http://www.ahbbo.com
Also, visit Elena's newest site, Web Work From Home http://www.web-work-from-home.com

Elena Fawkner is editor of A Home-Based Business Online ... practical business ideas, opportunities and solutions for the work-from-home entrepreneur. http://www.ahbbo.com
Also, visit Elena's newest site, Web Work From Home http://www.web-work-from-home.com

Dog Health Insurance

Should you seriously consider buying a dog health insurance policy? Yes, you should. Here's why health insurance for dogs is a good idea:

Dog health insurance saves you money. As with just about all other costs, veterinary expenses have increased rapidly in recent years. Without dog medical insurance (or more accurately, veterinary insurance), you are responsible for paying for everything: routine checkups, preventive procedures, emergency care and disease treatments. That will run into hundreds of dollars. Why not get some help?
Dog Health Insurance: Quick Cost Facts

* Health insurance for your dog, like health insurance for yourself, has annual premiums and deductibles.
* Pet insurance premiums depend on the breed of your dog and the type of policy you decide upon. If you have more than one dog, there is usually a reduced rate after the first policy. Dog health insurance deductibles can vary as well. The average annual deductible is about $100.
* You may choose among different coverage plans which are based on your dogs age, breed, and pre-existing medical conditions. Some policies even consider the dogs lifestyle; for instance, whether your dog is purely a pet or a watchdog, too.

Health Insurance for Dogs: Quick Coverage Facts

* Dog insurance healthcare plans can vary greatly. Some canine health plans are quite comprehensive, covering annual checkups, routine care, vaccinations and other preventive medications, and spaying/neutering, as well as illnesses and accidents. Others only cover unexpected sickness or injuries.
* Dog insurance coverage for emergencies begins immediately on most new dog health plans, with a 30-day waiting period for illness and other claims.
* Your dogs age can affect your dog's health insurance coverage. Typically, policies begin veterinary healthcare coverage when the dog is 6 to 8 weeks old, although some will start when the dog is younger. Similarly, some dog health insurance companies only will cover dogs under 8 years old unless the animal was already insured with them before turning 8.
* Many dog health insurers will not cover your pet if she has a preexisting condition or a terminal illness. Some will insure the dog only if the condition is controlled or stable, usually for 6 months.

With all these options, it is important you check out the various dog health insurance companies, their pet insurance policies and corresponding dog healthcare plans.

In short, if you care about your dog, you should care about his health. If you care about your wallet, you should care about your dog's health insurance coverage, too.

You can read more of Joel Walsh's articles on dog issues such as Dog Health Insurance at: http://www.i-love-dogs.com

The Modern Medical Office: Balancing Success, Technology, and HIPAA

The medical field has always depended on technology for improving patient care. Thanks to advances in technology, administrative functions of healthcare offices have greatly increased their efficiency and customer relations. For example, there is technology that allows doctors to share information with offices across street or across the nation instantly with just a few clicks of the mouse. These advances not only free up hours of paperwork, but also quickly provides information vital to patient?s care.

The Electronic Medical Office & HIPAA A clinic can in the end be more profitable by offering these innovative services. Nearly half of the people interviewed in a Forrester Research study said they would be willing to pay more for online features; such email access to their doctors. (1)

While technology can be tremendously beneficial there are serious cautions that must be heeded. In 2003, the privacy rule of HIPAA was enacted and the rules governing protected health information (PHI) of patients became far more stringent. The rule governs the way in which information is handled. It requires every level of communication and storage of the PHI to be secure and private.(2) Examples of the ways violations occur are:

• Computer screens visible from waiting room
• Files left out around the office
• PHI not disposed of properly, such as securely shredded
• Records sent to the wrong home or email address

Due to these changes all modes of communication have a heavier burden of responsibility placed upon them since the inclusion of the privacy rule, but none more than electronic transmissions. Keeping the information protected when sending emails, which can be intercepted, can in itself be a daunting task.

HIPAA?s Penalties If an action taken by any employee, whether intentional, unintentional, or simply neglectful leads to improper recipient of PHI, the practice involved could face serious consequences.

• The civil penalties range from "$100 per incident, up to $25,000 per person, per year, per standard that is violated."(3)
• The criminal penalties range in three main groups. The first is up to $50,000 and 1 year in prison, moving up to $100,000 and 5 years, or $250,000 and 10 years in prison.

Each tier of the criminal penalties has different qualifications leading up to the knowingly disclosing PHI with the intent for malicious harm. (3)

Keeping Your Practice HIPAA Compliant
It?s important for today?s electronic medical office to have several layers of digital protection. This ensures PHI or any other private information cannot go outside the confines of the practices? systems without the proper digital rights. These rights can be controlled by moderators or even the sender and have the ability to dictate what permissions the receiver may have.

One large step is to protect your practice from accidentally sending information into the wrong hands. This can be done through email anti-theft solutions which encrypts the data sent via email. By using these types of programs, the sender may control not only the security of the file but also subsequent actions that may be carried out by the file?s recipient(s).

email anti-theft programs allow the user to establish who can view, edit, print and forwarding these important health records. Permissions set with email anti-theft software stays with the documents once they?ve left the clinic?s computer.

What Happens if My Practice?s Computer is Stolen?
Email anti-theft software can also protect the data on the computer if the machine is ever misplaced or stolen. This can be done through remote laptop security. All the victim of theft has to do is log into the program and there remotely block access to all protected files on the missing laptop. Without improvement in the means of securing and transmitting their files many practices will continue to commit violations of HIPAA, losing money and patients along the way.

HIPAA Compliance & Patient Trust
It is obvious that one must comply with HIPAA because of the financial penalties that go with noncompliance. There are however, far better reasons for compliance than avoiding punishment.

HIPAA Violations can break the trust between doctors and patients, but compliance along with new technology can strengthen relationships. When patients have new services such as the ability to ask questions to doctors via email the doctors can enhance their trust levels. This is especially important for small practices as interpersonal relationships play key roles for the retention of patients.

The advantages of technology will continue to provide new ways of serving patients. As the digital age comes the computer will increasingly become the focus of record keeping. With an industries like medical & healthcare so dependent on keeping detailed yet secure records, it is going to be ever important to stay current with strong security programs to encrypt and protect files.

1. Bradford J. Holmes, Eric G. Brown, Elizabeth W. Boehm, Lynne Bishop, "Trends In Healthcare Consumer Technology Adoption" Forrester Research, 15 July 2004.
2. Title 45 Code of Federal Regulations, Pt 164.
3. United States Department of Health and Human Services. Protecting the Privacy of Patients' Health Information Summary of the Final Regulation. 2005. http://aspe.hhs.gov/admnsimp/final/pvcfact1.htm
   Michael David is a member of the marketing team at Essential Security Software (ESS), the leading provider of email anti-theft software for small business. He is a regular contributor to http://www.Iwantmyess.com.

HIPAA Software

The future of your medical practice could greatly depend on how well you comply with HIPAA. As there are complex procedures and you have to keep record of various steps apart from ensuring the security of the information you have access to, most the employers and medical professionals prefer to use HIPAA software.

The software is available online as well as offline, which helps the people concerned with implementing this law. In fact, this software can make the difference between success and failure, for a large number of medical professionals. The HIPAA software helps in removing inefficiency, which causes trouble for many health service providers.

If you plan to run a medical office without sapping too much of your time in dealing with administrative and data management problems, then HIPAA software can be of great help. It provides help in managing almost every aspect of a medical office, such as billing, scheduling, processing of claims, auditing, recording and reserving medical information. It reduces costs as well as the margin of error in managing health care services, and helps in improving the overall productivity of the staff.

Good HIPAA software should ensure that you are complying with all the HIPAA rules and regulations. You must not forget to get your software updated as new rules and regulations are incorporated. A list of such software programs is available on several websites. You can purchase them online. A number of software companies sell HIPAA software.

Do check the performance on trial basis before you pay the full price, as not all software would fulfill your requirement. The choice of software also depends on the type and size of your organization, as well as volume of data that has to be loaded and processed by this software.



HIPAA provides detailed information on HIPAA, HIPAA Compliance, HIPAA Laws, HIPAA Software and more. HIPAA is affliated with Electronic Medical Record Systems.

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.