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HIPPA and Cobra Stuff

Discussion in 'Social Security / Disability Benefits' started by raggedyann1, May 28, 2006.

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  1. raggedyann1

    raggedyann1 Registered

    I learned a lot about the Hippa law recently I hope this information is helpful to others.

    First off when you say your Cobra is running out soon do you mean your 18 months are running out? Or the 29 months (11 month extension available for ill people unable to work)? There are extra months available on cobra for specific situations and also in California.

    When your Cobra is running out you are eligible for health insurance, but the rules are very specific.
    1. You must obtain your Hippa insurance by the 63 day after your Cobra ends - no ifs ands or buts.
    2. Any company selling individual or family health insurance in your state must offer you 2 different HIPPA options - they may not turn you down for prior health - meaning there is NO medical underwriting.
    you should do some research on the internet and find the names of every company selling health insurance in your state. It takes several hours to do this but is worth the time spent. I found insurance agents only offer the policy they make the most commission on.

    Things to double check when comparing different HIPPA policies
    1. What is their medication coverage. Is it generic only? is there a deductible? is there a maximum they will pay?
    2. What is the copay for doctors visits
    3. What tests and procedures do they cover
    4. If you have a specialist that you want to keep is he covered under the plan.

    I was in for a big price shock when I shopped fro my husband. He had been on my health insurance and my cobra ran out - my medicare was starting so we didn't have to worry about me. But the cost of his medications was exremely high. I had very good health insurance thru my prior employer that was very reasonably priced - come to find out that they were a self-funded plan which is why the price was so low.
    When we compared all the numbers the cheapest plan had the best coverage for medication with no limits - and that was our primary concern. It was cheaper to buy the insurance and pay the copays for the meds than it was to just pay cash for the meds and have no insurance in case of an emergency.

    If you are switching companies that you work for or your significant other is HIPPA will help you here also.
    As long as it is less than 63 days then most pre-existing condition clauses are not valid. The key is to not have more than the 63 days. Often new employers have a 90day wait before insurance begins. What you need to do is to cobra your insurance with the prior employer for at least 30 days but may be worth 90 days depending what your medical costs would be if you went without insurance for a month or two.

    Any employee of a firm with more than 25 employees is eligible to use Cobra- even if the reason you left was being fired. All you need to do is tell the HR department with in 30 days of the end of your insurance that you wish to cobra your insurance. They will have forms sent to you.

    The key with cobra policies is that there is a limited grace period. For the first month it is 45 days to allow for paperwork to be processed and all. After the 1st month you must pay by the end of each month to maintain your insurance. If you have not mailed your check before the end of the month you will lose your insurance and lose all HIPPA rights as well. It is better to make sure the employer receives the check before the end of the month so you don't have trouble filling prescriptions at the beginning of the following month.

    I hope all this information is clear.

    Karen
     
  2. zara

    zara asleep at the meal

    Excellent information, Karen!!! I'm sure I'll be referring back to this again and again.

    Thank you. [​IMG]
     
  3. barefut

    barefut Guest

    Yes, Thanks Again Karen! [​IMG]
     
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