Understanding Health Insurance Coverage: A Primer

Health Insurance Coverage: What are Covered Services?
Health insurance coverage is a contract used to determine medical benefits that are covered, or not covered, between you and your insurance provider. The insurance company, based on a fee that you provide them on a regular basis, promises to pay health insurance coverage on certain items or benefits listed in that contract. These are called covered services. Covered services can include a wide variety of things, such as implements, prescriptions, services (such as massage), checkups, tests and/or research.

Your contract should also list all of the things NOT covered in your health insurance coverage these are items or services that you will need to pay for out of your own pocket, should you require them.

Health Insurance Coverage: What is a Medical Necessity? How is this Different from Covered Services?
Just as it seems, a medical necessity is something that your health professional has deemed a required service/ item that will affect your health negatively should you decide not to purchase it. However, just because your doctor tells you something is a medical necessity does not mean your health insurance actually offers coverage for it.

Since insurance companies decide what health coverage they will and will not provide, you really have no leeway in this area.

Health Insurance Coverage: What Do I Do?
Most doctors try and keep themselves abreast as to what the major insurance companies do, and do not cover when it comes to health coverage. However, there are a LOT of plans out there, so this just isnt enough. So how can you avoid any nasty surprises during an emergency?

Read your health insurance coverage. Youre better off knowing what your health insurance company will, and will not provide coverage for right off the bat. Then, if your doctor decides on a treatment plan that isnt covered, you can ask for alternatives that may be.
If there are questions regarding your health insurance coverage, do not hesitate to contact the insurance company. Questions are good, and they expect them.

Health Insurance Coverage: What Do I Do if Something I Need Isnt Covered?
The gross majority of what your doctor orders for you will be covered in your health insurance plan. If you do get a treatment or supply that isnt covered, you can always challenge the health insurance coverage. You may not be the only one who requires the same type of service, benefit or item so youll end up fighting not just for yourself, but for others in the same situation.

Ask your doctor for their side, and use this in your claim. It may not help in the end, but if your doctor is on your side, you may be able to convince the health insurance company that coverage is required.

For more more information about health insurance coverage please visit http://www.1health-center.com/articles/Health-Insurance-Coverage.php

Natural Health Insurance: 3 Proven Immune Boosters

As important as it is to make sure you have 'normal' health coverage, it's even more important to increase the amount of 'natural' health insurance you have. After all, if you protect your body now you won't need to worry about paying a big doctor's bill later! One of the best ways to do this is by boosting your immune system and helping your body to fight off disease.

The following tips are some of the most effective methods for boosting your immune system naturally. Each one is absolutely proven to help protect you from a wide array of diseases, including heart disease and cancer. Incorporating them into your lifestyle is one of the easiest ways to 'buy' natural health insurance!

Eat Colorful Vegetables & Fruits

These extremely healthy foods should be the basis of your diet. Eating colorful veggies and fruits is a must if you want to stay healthy for life. They are packed with essential vitamins, minerals, fiber, and phytochemicals that keep your body -- and your immune system -- strong and ready to fight off disease. Choose things like leafy greens, bright red tomatoes, orange grapefruits, yellow peppers, and plump blueberries. Remember, the more colorful your plate is the healthier you're going to be.

Get 8 Hours of Sleep

There is no longer any doubt that lack of sleep affects the immune system and leads to health problems. Several recent studies have shown that getting a good night's sleep can dramatically boost your immune response, while even one night of poor sleep can significantly suppress immune function. The immune system is constantly working, so when we sleep the body is able to 'reinforce' and strengthen it, most likely by producing powerful hormones. Most people need about 8 hours of sleep per night for optimal health so that's a good number to shoot for.

Exercise 6 Days a Week

Exercise is a powerful immune booster, not to mention a very important component of good overall health. Regular, moderate exercise has been shown to lower an individual's likelihood of getting sick. It also boosts natural energy levels while relieving stress at the same time. To top it all off, regular exercise makes it much easier to sleep at night! Just don't overdo it. Too much exercise can actually suppress the immune system. Try to get about 30 to 40 minutes of moderate exercise most days of the week, leaving one day for rest and recovery.

Well, there you go -- 3 powerful and proven ways to boost your immune system and stay healthy. Each of the above are healthy habits which, over time, will provide you with an abundance of natural health insurance. If combined, you'll enjoy great health and wellbeing for a very long time!

Ryan Wilson is a writer for Natural-Health-Insurance.com, a guide to useful news & information about staying healthy. You can learn more at: http://www.natural-health-insurance.com/.

Note to web site owners: Feel free to use this article on your site or newsletter. Just be sure it includes a 'live' link back to Natural-Health-Insurance.com

No Living Will & Power Of Attorney?: HIPAA Law Shuts You Out

What do you mean I can't find out about my husband's accident injuries? Why can't we move my mother to the nice nursing-home down the street? The Health Insurance Portability and Accountability Act or HIPAA caused two of my clients to live through these very situations.

A husband and wife were involved in a terrible automobile accident. The husband was seriously injured. His wife wanted to make certain that the needed medical attention was given to her husband. The wife could not get any medical information from her doctor. Even though she was the wife, the new HIPAA law and regulations prevents her from receiving medical information without specific written authorization!

In another case, an elderly widow lady became incapacitated. Her two children wanted to place her in a nursing home so that she would receive adequate care. Even though they had a living will and health-care power of attorney for their mother, they were required to go to court and be appointed her guardians so that they could place their mother in the health care facility.

What is the HIPAA Law all about?

The HIPAA Law in a Nutshell

HIPAA took effect on April 14, 2003.

This legislation applies to virtually every physician, nurse, pharmacist, dentist, and health care provider in the nation. It impacts everyone's access to health care information.

What does this privacy act mean? The regulations stress that health care providers must limit health information to those who are intended to receive it. This means health care information cannot be released to any unauthorized person. This may mean you may not be able to receive medical records for your spouse or parent.

HIPAA Violation Penalties

The penalties for health care providers are staggering. For each disclosure violation, there is a $100 fine. If the violation is knowing, there are criminal penalties of a $50,000 fine and up to one year in prison. If information is provided or obtained under false pretenses, there is $100,000 fine and up to five years in prison. If the wrongful sale, transfer or use of the information was for commercial advantage, there is a $250,000 fine and up to 10 years in prison.

How does this affect you? To ensure an easy transition, you must have the appropriate medical release language to comply with HIPAA in three of your estate planning documents.

Documents to Update

The documents which need to be updated are:

• Your Living Will and Health Care Power of Attorney
• Your Living Trust
• Your Durable Power of Attorney

What if I do nothing?

You may be forced to sign the doctor's or hospitals forms in a stressful emergency situation. These documents may not reflect your choices and may contain confusing legal and/or medical terminology. Or you may be unable to sign anything and may repeat one of the above scenarios.

If your documents were created before 2003 and have not been amended since, have your attorney review them for HIPAA compliant language. Are you missing some or all of these documents? Make an appointment today!

Visit http://www.stevenallen.com for tips and tools on Wealth Preservation. You can also subscribe to his monthly newsletter Secrets To Wealth Preservation. Steven W. Allen has been an Estate Planning attorney for over 30 years. He is a member of the Arizona Bar Association, National Lawyers Association, National Academy of Elder Law Attorneys and National Speakers Association. He is the author of four books including the most recent You Can?t Take It With You...So How Will You Leave It Behind?. Go to http://www.EstatePlanningDr.com for your 3 free chapters.

HIPAA and Document Imaging

The Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996 and has made quite an impression on the world of digital document imaging and forms processing. Any company as a covered entity of HIPAA needs to take certain precautions when outsourcing any aspect of their operations that deal with personnel health information (PHI.) There are two main components to HIPAA that deal directly with the outsourcing of document imaging and claims processing. Privacy issues and Administrative Simplification are of the utmost importance to HIPAA.

If you have been to doctor?s office the last few years, you probably have been asked to sign all kinds of new forms; these forms are HIPAA privacy forms. It does not end with privacy and disclosure forms, people handling medical information must take special precautions when handling private medical information. This information includes but is not limited claims, patient history files, and enrollment files.

Whenever dealing with a Document Imaging Service provider you should always ask them about their HIPAA policies and procedures. Every one of their employees needs to sign an agreement stating they are aware they are handling people?s PHI. The company should have a zero tolerance policy on distributing or reading anyone?s PHI. Every care and precaution must be taken to ensure PHI remains private.

Under the privacy rule of HIPAA there is a security rule which has three parts:

1. Administrative Safeguards ? are policies and procedures designed to clearly show how an organization will comply with the HIPAA act.
2. Physical Safeguards - Physical access to PHI must be restricted and controlled to guard against inappropriate access to such data.
3. Technical Safeguards ? Any organization engaged in the handling of PHI must control access to computer systems and protect communications containing PHI. These communications must be protected against interception.

The primary goal of the Administrative Simplification portion of HIPAA is to simplify and streamline the administration of health care. Essentially, standards are created to facilitate various types of health care electronic transactions. No one insurer can ask any claims submitter to file in any other electronic formats other than those mandated by HIPAA.

A little bit of work up front will pay off in time. If you use an experienced service bureau or clearinghouse to process your claims, they will be able to convert your paper claims according to the standards set fourth by HIPAA with little effort. Once you successfully submit claims in the HIPAA standard ANSI 837 format, submitting to another insurer will be a piece of cake.

Under the old system, one health care provider could require all claims submissions to be in a HL7 format while another could require a custom text string. There were about 400 different ways to submit an electronic claim before HIPAA. Now there is one way, HIPAA's Way.

• Less setup for new claims submitters (One size fits all)
• Easier training for new staff
• Faster payments

If you feel the company you are doing business with is not serious about HIPAA, find another company to do business with. In the end you are responsible for the actions of your contracted vendors. Any vendor dealing with PHI is also considered a covered entity of HIPAA and therefore legally bound by the act.

We are a NY document imaging company dedicated to finding you the right solution for all your digital data needs. We believe in providing you with all the necessary information and expertise to help you make a sound decision regarding your data processing projects. For more information visit our website at http://www.paper-scanning-services.com

HIPAA Compliant FTP Hosting

FTP Hosting ? an overview

?File Transfer Protocol?, commonly known as FTP, is a reliable protocol to exchange large volume of digital information from one computer to another. FTP hosting technique has simplified file transfer process over the Internet. FTP hosting comes with two components ? FTP Server and FTP Client. Moreover, each FTP user will get a unique FTP account with user name and password. Irrespective of file type and file size, FTP account holders can upload the files in FTP Server through their FTP account. Similarly, FTP account holders can download copies of the uploaded files from FTP Server.

FTP hosting services provides complete security in file exchange process. Only authorized FTP account holders can view and access the files. Further, you can restrict a FTP account holder to access other FTP accounts. Irrespective of business volume, companies require to transfer files over the Internet. Though it is true that Hyper Text Transfer Protocol (HTTP) provides the facility to share information over the Internet but due to its limitations, FTP became popular across the globe.

FTP Hosting for Health Care Services

In Medical Transcription or other Health Care Services, medical reports are stored and exchanged in digital format. The growing necessity of exchanging large volume of medical reports and files over the Internet allows the Health care Service providers to use File Transfer Protocol as an alternative of Hyper Text Transfer Protocol. After the introduction of Health Insurance Portability & Accountability Act of 1996, extra guidelines are drawn for FTP hosting. All types of Health Care Services, who store and exchange medical files and reports over the Internet will fall under this Act and have to follow HIPAA regulation throughout the business process to ensure quality service and security of digital medical files and reports.

HIPAA

Health Insurance Portability & Accountability Act, commonly known as HIPAA, is a set rule to protect health related electronic information. The effect of HIPAA rules is applied to all types of health care organizations and support services. According to Health Insurance Portability & Accountability Act, all the health care organizations and support services should maintain necessary security measures to protect personal health information.

Medical institutes and support services prepares and stores health information of the patients in digital format. Based on the requirement, these digital reports are exchanged from one computer to another over the Internet. Health Insurance Portability & Accountability Act ensures complete security of digital health information that includes ? secure storage system and secure transmission of digital information over the Internet.

HIPAA Compliant FTP Hosting

The growing importance of Health Insurance Portability & Accountability Act in health care sector has given the birth of HIPAA compliance FTP hosting services. The objective of HIPAA compliance FTP hosting services is to protect unauthorized people from accessing digital heal information or medical report.

Following are some general features of HIPAA compliance FTP hosting service:

• HIPAA compliance FTP servers are considered as highly secured data centers.
• The system will automatically generate and run several threads during transferring digital medical files from one location to another. This is known as Multi-thread File Transfer and makes the process faster than normal File Transfer Protocol.
• HIPAA compliance FTP hosting service comes with 128-bit transfer encryption. Digital files are transferred in the encrypted form. There is also another process ? symmetric or secret key encryption, which encrypt files and upload them in the server with a unique ?key?. The system will store the encrypted data in HIPAA compliance FTP server. Only the authorized person, who has that ?key?, can download the encrypted digital medical report from the server.
• Like general FTP hosting services, the methods of uploading and downloading digital medical files are user friendly.
• HIPAA compliance FTP hosting services allow the users to apply FTP services with existing firewalls.
• Unique user name and password for HIPAA compliance FTP account holders.
• HIPAA compliance FTP hosting services restrict anonymous FTP account holder from accessing the server.
• Some HIPAA compliance FTP hosting services provides ultimate security by using ?Intrusion Detection System? and other security tools, which are compatible with all types of operating systems.

Advantages of HIPAA compliance FTP Hosting

The main advantage of HIPAA compliance FTP hosting services is data encryption. HIPAA compliance FTP hosting services will encrypt each data files in separate pieces of data, which are known as ?key?. You have to use the software xTyFTP during the process of uploading medical records in the FTP server. The software will encrypt the digital file in the computer and provide the ?key? to the authorized user decrypt.

HIPAA compliance hosting services will store the encrypted file in the server. However, if any unauthorized user accesses the file from the FTP server, he/she will get the encrypted form and the content will remain hidden without the right ?key?.

Apart from data encryption, which is considered as the core feature of HIPAA regulation, HIPAA compliance FTP hosting service requires secure procedure in data handling and serious maintenance of necessary policies, e.g., restricting unauthorized users from damaging digital information.

Adam is a Network Engineer with "InstantFTPsites.com". You can learn more about "FTP Hosting" services online at http://www.InstantFTPsites.com.

? 2006 InstantFTPsites http://www.InstantFTPsites.com You may reprint this article online and in print provided the links remain live and the content remains unaltered (including the "Author Biography").

HIPAA Made Easy

HIPAA made easy

In 1996, a major legislative act was passed affecting health care administration called the Health Insurance Portability & Accountability Act or HIPAA. Whenever the legislature writes new laws it's up to the rest of society to understand the legal jargon and find how what the new law is all about. That's the aim of this article- to help simplify and state the main concepts of HIPAA.

There are two main parts to HIPAA that need to be understood. * The first part of HIPAA amended the Internal Revenue Service Code of 1986. * The second part is directed at streamlining and standardizing some of the administrative aspects of health care administration and information systems.

The second role of HIPAA is what will be focused and discussed as this is the part which mostly affects health care providers. Again the purpose of HIPAA was to simplify health care administration. There are deadlines for compliance; HIPAA does provide penalties and legal action for noncompliance. There are four parts to HIPAA: * Standards for Electronic Transactions * Unique Identifiers Standards * Security Rule * Privacy Rule Before HIPAA there really wasn't much standardization among health care providers regarding filing claims and identification. This created a lot of problems, headaches and extra work. HIPAA aims at saving time and making the process more efficient. It affects how health care providers file and process claims and conduct other business electronically. HIPAA also makes provisions for how health care providers are identified. There was no standardized way of identifying health care providers in: (1) being identified to Medicare and other government health organizations and (2) in being identified with other health care providers. The security and privacy rules were created to ensure secure transmission of electronic data and to protect individuals' personal medical information.

Many health care providers use electronic means for filing, billing and claim work. There has yet to be any adopted standards for this, with each individual provider using whichever forms they like. This led to complications in filing claims with Medicare and in transferring information from provider to provider. HIPAA has changed that though making electronic filing forms standardized. When filing electronic claims or when sending an electronic medical record providers will now be using the same forms. Medicare will require that all providers use the same form when filing an electronic claim with them. Providers who do not file or process claims electronically will not be affected by HIPAA. Also a standardized set of codes must be used on records in relation to physical conditions, diseases, health, etc. Most providers and institutions already use this practice. There will be enforcement of compliance; HIPAA has set deadlines for when providers must be using the approved forms.

Also new with HIPAA is how providers will be identified. Health care providers, doctors, hospitals and health plans are required to have a unique identifier and current they are using either tax-id numbers or employer identification number.

The security and privacy rules contain provisions to ensure that people's personal records and information will be protected and kept confidential. Along with all other privacy laws there will be penalties for non compliance, HIPAA provides for fines up to $250,000 and possible jail time for severe enough violations. But don't be worried about too many places avoiding compliance, HIPAA was created to make the massive process of health care administration easier.

Rick Lorenzen writes for 10x Marketing. To learn more about HIPAA compliance, electronic claim software and electronic medical record software visit www.AdvancedMD.com.

HIPAA Compliance 101

What is HIPAA?

The U.S. Congress ordained the Health Insurance Portability and Accountability Act (HIPAA) in 1996. Title I of HIPAA protects health insurance coverage for workers and their families when they lose or change their jobs. According to title II of HIPAA, the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. The AS provisions also address the security and privacy of health data. The purpose of all these standards is to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in health care.

The AS provisions are applicable to only ?covered entities?. Covered entities are those health care providers (e.g. doctors offices and hospitals) which engage in electronic transactions as per the HIPAA/EDI rules, health plans (which includes health insurance companies and employer-sponsored ?group health plans?), and health care clearing houses.

Applying HIPAA Provisions

Certain key provisions need to be followed for HIPAA compliance. Individuals should be able to access their records and request correction of errors. Also, they should be informed about how their personal information will be used. The ?protected health information? (PHI) indicates that the information cannot be used for marketing purposes without the explicit consent of the patients in question. People should be able to ask their covered entities (which maintain PHI about them), to ensure that their communications with the patient are confidential. It should be possible for people to file formal privacy-related complaints to the Department of Health and Human Services (HHS) Office for Civil Rights. Covered entities should document their privacy procedures, however, they have discretion on what to include in their privacy procedure. Covered entities are required to designate a privacy officer and train their employees. Covered entities can use an individual's information without the individual's consent if the purposes is to provide treatment, obtain payment for services and to perform the non-treatment operational tasks of the provider's business. Chris Tolamalu is interested in HIPAA compliance. See http://www.hipaacompliancejournal.com for more information.

Are you HIPAA Compliant?

A closer look at HIPAA
By - Matt Sears, Senior Vice President
Athens Benefits Insurance Services, Inc.
A division of The Jenkins Athens Group

HIPAA. Perhaps one of the most significant laws in recent memory; certainly one of the most complex. While this short article won't make anyone an expert, it will, hopefully, demystify this wide ranging set of laws and put you on the path towards compliance.

First, let's answer the question; “What is HIPAA?" HIPAA stands for the Health Insurance Portability and Protection Act of 1996. Although it purports to regulate health insurance, HIPAA provisions extend far beyond insurance. HIPAA introduced broad disclosure and privacy requirements. It also established civil and criminal penalties for each violation (up to $25,000 per person per year in civil penalties and up to $250,000 in criminal fines - along with imprisonment).

Title I of HIPAA deals with portability and special enrollment rights for health plans. Those conditions must have been incorporated into your plans by now (original compliance date was 1997). Title II of HIPAA governs a wide ranging set of conditions called, “Administrative Simplification". For those charged with compliance, the notion that HIPAA simplifies anything qualifies as “dark humor". Administrative simplification attempts to create a uniform system for processing and retention of health information and ensuring the security of that information.

For the purposes of this article, we're only concerned with those portions of the law impacting most employers...privacy. Notably the privacy of personal data defined by HIPAA as “Protected Health Information" or “PHI" - information that is personally identifiable. In the broadest summary possible, key components of HIPAA privacy requirements for a plan sponsor are fairly straightforward:

Generally, the employer (Plan Sponsor) is not a HIPAA “Covered Entity" - the Health Plan is. For fully insured plans, this typically means the health insurer, HMO, EAP provider, etc.
As the Covered Entities, health plans bear the brunt of compliance requirements (your responsibilities become exponentially larger as the quantity of data you receive increases)
Meet with every service provider, or ensure that your broker or consultant has reviewed compliance requirements with each
Use protected health information only for needed administration of the benefit programs (HIPAAspeak: “Treatment, Payment and Health Care Operations)
Collect (and release) only the minimum data required to “do the job" (e.g. enroll an employee, file claims, etc.)
Restrict the data to those persons who absolutely must use it
Establish “firewalls" and safeguards to protect the data (separate locked files, restricted access, password protect systems)
Appoint a Privacy Official (not required for fully insured plans that never receive PHI)
Create a Privacy Policy and distribute a Privacy Notice to participants
“Scrub" personally identifiable data from communications pieces, ID Cards, etc.

HIPAA, like COBRA before it, will continually change as new rules and regulations are released (for example, the U.S. Dept. of HHS has yet to release enforcement rules for HIPAA). Ongoing compliance will require vigilance in remaining up to date on the changing laws. It's vital your broker/consultant proactively work with your organization to review plans, identify problems and provide ongoing education to maximize the performance of your benefit plans.

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.