Friday, April 24, 2009

10 Ways to Keep Health Coverage if You Lose Your Job

Top 4 that I found interesting from National Center for Health Policy Analysis: (read all 10 here)

6. Shop for Individual Coverage. There may be cheaper alternatives to COBRA, especially if you have no severe health problems. For example, a Dallas family of four with both parents in their 20s could buy a preferred provider organization (PPO) plan with a $2,000 deductible for a $4,680 annual premium. That same family's annual COBRA premium would be closer to $13,000, on average. If the family chose a $5,000 deductible, the annual premium would be less than $3,500. Some of these plans also qualify for an HSA, allowing the policy holder to set money aside tax-free to pay medical expenses. You can contact independent insurance agencies to compare policies or shop online at sites that compare prices, such as Some insurers even offer short term medical "gap" coverage for people between jobs, retiring prior to Medicare eligibility, or not yet eligible for company benefits and for students about to graduate.

7. Even if You Are Uninsurable, You May Be Able to Get Insurance. Under federal law, people who have been continuously insured with no significant gaps in coverage (that is, no more than 62 days), cannot be denied individually purchased coverage because of health status. Different states enforce this federal requirement in different ways. Some states require insurers to accept all applicants, regardless of pre-existing conditions. However, in states with so-called guaranteed issue regulations, premiums are often two to three times as high as those in states that allow insurers to charge premiums based on health status. More commonly, 35 states have high-risk pools to insure those who are turned down by commercial insurers. Twenty-nine states requires insurers to make at least one "guaranteed issue" plan available to those who have been continuously covered, regardless of health status.

9. Consider a Limited Benefit Plan. Limited benefit plans - sometimes called mini-meds - have a maximum annual benefit. They may pay for a set number of office visits per year and may only cover generic drugs. These policies usually also cover some hospitalization. However, benefits may be capped at a maximum of, say, $10,000, $25,000 or possibly $50,000 in a given year. When Tennessee moved many families on its Medicaid program (TennCare) to limited benefit plans, about 98 percent of enrollees never exceeded their $25,000 annual maximum.

10. Join a Concierge Physician Practice. Some innovative physician practices provide primary care in return for monthly (or annual) fees. Dallas-area physician Nelson Simmons offers a package of services for less than $500 a year. About 70 small business owners pay $40 per employee per month for Simmons' plan. In return, employees get same-day primary care services and steep discounts. Enrollees must pay out-of-pocket for specialist care, surgeries and diagnostic tests, but Simmons negotiates the rates with providers. The total out-of-pocket cost is typically much lower than what you would pay as an uninsured individual. For example, a tonsillectomy for a child costs less than half of the normal fee ($2,100 versus $4,800) and an MRI scan can be less than one-fourth the standard rate ($350 versus $1,600).

An Arizona-based firm, the No Insurance Club, has a package that allows individuals to see a primary care physician up to 12 times per year in return for an annual fee of $480. A family can share 16 visits per year for $680. Generic drugs are discounted and most routine lab tests are low cost or included in the annual fee. This type of arrangement may even be combined with a catastrophic health plan to ensure a major illness doesn't turn into a financial catastrophe. Physicians are joining the practice in selected cities nationwide.

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