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Health Insurance; COBRA; OBRA; HIPAA;has what is called a "pre-exisitng coverage"
Medicare. If asked, could you state that youcondition.Here again, before automatically
knew that all 5 of these topics had the sametaking COBRA, it would be wise to contact a
thing in common: medical insurance coverageBenefits Insurance Broker and give him/her
for you and, perhaps, your family? Would youall of your options, and get their input. I
know the qualifications for each? Well, inhave worked extensively with a Benefits
this article, we will discuss them. For aInsurance Broker, and he is absolutely
timeline that depicts, graphically, the timefantastic!OBRAWhat, you ask, is OBRA? I've
relationship between them, please see thenever heard of it, you say, and no one I know
timeline in INSURANCE Coverage from WorkIfhas heard of it either! Well, that's because,
we are lucky, we, and/or our spouse, work for99% of Human Resource or Benefit folks that I
a company that provides, as a benefit, healthknow have never heard of it! OBRA is a
insurance coverage for us and our family. Iffederal law that was passed that extends
so, we are very lucky. Even if that is true,COBRA for an additional 11 months FOR
there are some key things that you might wantDISABILITY PURPOSES ONLY!! Why, you ask, is
to look at to see if you have ENOUGHthis important? Thanks for asking, let's see
coverage.1) From your Human Resourcesif I can explain.If you are as nieve (did I
Department (or wherever else you would go tospell this wrong too? sorry!) as I was when I
get information about your health insurance)first started looking to bridge my health
get what is called a "Summary Planinsurance from working to Medicare, I assumed
Description" (SPD). This document should bethat when I got through all of the hoops to
kept where you can always find it, as itqualify for SSDI (Social Security Disabililty
contains all the information you will needInsurance) I'd IMMEDIATELY be eligible for
about what your insurance covers and what itMedicare, RIGHT??? WRONG!!!!When you FINALLY
doesn't.2) Look up "Coverage" andqualify for SSDI, you have to wait for 5
"non-coverage" in your SPD.These will tellmonths before you get your first check. AND,
you what your plan covers and doesn't cover.the rules state that, you are eligible for
You need to see if, perhaps, you or one ofMedicare 2 years (24 months) FROM THE DATE OF
the covered members of your family has aYOUR FIRST SSDI PAYMENT. Well, if you add 24
condition or circumstance that might not be+ 5 you get, 29 months between qualifying for
covered, where you need additional coverage.SSDI, and Medicare coverage.OK, I said
For example, let's say that your family has aearlier that COBRA is for 18 months of
history of cancer; perhaps your plancoverage. Well guess what 18 months of COBRA
restricts the number of hospitalization days+ 11 months of OBRA equal - 29 months!BUT,
for care; or, restricts the days perthere are two catches to OBRA; first of all,
condition. In this case, (like my children)you have a small window of 30 - 60 days to
you might want to get additional "cancerapply ( this window opens the date of your
insurance" (I think that AFLAC might provideSSDI approval); and, it can cost up to 150%
this type of coverage).It would be a goodof your plan coverage amount. BUT, if you
idea to contact a Health Insurance benefithave a "previously existing condition" this
Broker and ask him/her to read your SPD andmight be the best way for you to
see if you have any gaps in coverage. Theyproceed.Again, it is important to contact a
then can help you supplement coverage BEFOREHealth Insurance Broker to help you with the
YOU NEED IT!NO HEALTH INSURANCE COVERAGEYourisk/cost ratio of all of these situations.It
might be one of the growing members of ouris also improtant to know all of these
society that, through one circumstance ordeadlines as you plan to ensure that you and
another, does NOT have health insuranceyour family have important health insurance
coverage for your family. In this case, Icoverage.HIPAAHIPAA is a federal law that is
strongly encourage you to contact a Healthcalled, briefly, the "portability" law for
Insurance Broker and get immediate coveragehealth insurance. What that means is that
of what is called "catestrophic" (not sure ifwhen you leave a group (read company-paid
I spelled this correctly) coverage. In thisplan), the carrier that provided that plan,
type of coverage, you will generally havemust offer to you, another plan, different
large deductibles, but will have coverage if,from COBRA, when you leave the group
say, one of you has to go into thecoverage. Generally this will be what is
hospital.CONTACTING A BENEFITS INSURANCEcalled a "bare bones" plan. Again, the best
BROKERWhenever you call or email a Healththing for you to do is to call/email a Health
Insurance Broker, it is very important toInsurance/Benefits Broker with all of your
prepare ahead of time. WHAT, specifically areinformation: SPD, COBRA info, HIPAA info,
you looking for; how much can you afford toneeds, cost limits, and let him/her help you
pay every month; what circumstances do youfind the optimum plan coverage for
want to make sure that your family is coveredyou.MEDICAREOK, now, finally, we've reached
for. In this way, you can make sure to focusMedicare! BUT (you really didn't think it
on your critical needs.COBRACOBRA is anwould be that easy, did you?) if you have
acronym ( how can I spell acronym correctly,qualified for Medicare because of disability,
yet not be sure that I spelled catestrophicthere are RESTRICTIONS (of COURSE there
correctly?) that stands for: Consolidatedare!).First of all, if you are qualifying for
Omnibus Budget Reconciliation Act. Basically,Medicare because of disability, you are
it is a federal law that allows you to payprobably under the age of 65 - normal
for your Company-paid health insurance, as anretirement age.Medicare coverage does NOT
active member, if you no longer work for thatcover prescription drugs, which, those of us
company for, generally 18 additionalwith disabilities probably need, and which
months.1) COBRA is "triggered" (that is, you,cost lots.But, Congress prescribed that
or a covered member of your family, becomestates (all but 11) offer what is called
eligible for COBRA) by events such as the"Medicare supplement" plans, some of which do
following: resignation from the company;offer  prescription  coverages.
termination (FOR ANY REASON) from the
company; divorce of a spouse; a coveredBUT, these plans ARE NOT REQUIRED TO, and do
chile's birthday makes them ineligible fornot, offer these medicare supplement plans
coverage. These are the main "triggering"that offer prescription coverages to folks
events for COBRA.2) Now, when eligible forwho qualify under age 65! So, if you are
COBRA, you will be asked to pay for 100% toqualifying because of disability, your
105% of the company's employee/employee andmedical insurance plan doesn't cover one of
family coverage amount. You should get ayour primary cost expenditures!Here again is
letter from your company explaining what thatwhere you need to contact a health insurance
amount will be. BEFORE YOU DECIDE TO TAKEbenefit broker. Again, he/she can work with
COBRA, there are some important things foryou, and your specific circumstances, to get
you to consider.What will be your cost, andyou the coverage you need.Hope that this
what  will  be  the  coverage for that cost?information was helpful to you. If you have
any questions, please feel to ask them by
Sometimes the cost is too much for thecommenting on this blog, and I'll be happy to
coverage. In these cases, you might want toget you an answer.About & Carolyn is a
select HIPAA coverage, instead (see HIPAAwebsite designed to assist each person in his
below).Or, you might just want to gether own unique quest to navigate through the
catestrophic coverage as was mentioneddifficult and often conflicting and
earlier, and wait for full coverage undermisleading information about coping with
your next job.Part of this decision should bedisabilities.
whether or not you or a member of your family



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