Professional Insurance Programs

I’m Between Coverage: Is COBRA my only option?

You have come to a point in your life where you find yourself between health insurance coverage. Commonly, this is where COBRA steps in. What exactly is COBRA?

COBRA, short for the Consolidated Omnibus Budget Reconciliation Act, grants former employees, retirees, spouses and dependents temporary access to the same benefits they received on their previous employer’s plan, usually up to 18 months. In the event you choose COBRA while between coverages, you are responsible for the entire premium rather than just some of the premium, as most employers pay for part of your coverage common to an employee benefits package. Furthermore, you will continue to have coninsurance, deductibles, and copayments. Additionally, COBRA carries an administrative fee up to 2%. COBRA would be right for you if:

– Your doctor is out of network on other plans

– You reached your deductible before your coverage ended

What if those scenarios don’t apply to you? Here is where we can provide you with more options to cover your health between coverage.

Option 1:

Alternative Choice Plan

This short-term plan offers temporary coverage from 30 to 364 days or two back-to-back six month policies. This plan is ideal for people who are:

-Looking for an alternative to health care reform plans

– Recent college graduates

– Part-time or temporary employees

– Between jobs and looking for an affordable alternative to COBRA

– Newly employed and waiting for health benefits to begin

– Waiting for Medicare eligibility

Regardless of which option you feel is right for you, it is important to not let your coverage lapse. If the unexpected happens without coverage, you and your family will be responsible for 100% of all medical costs that may occur.

Option 2:

Special Enrollment Period (SEP)

You may be eligible for SEP if your health insurance ended due to: loss of job-based coverage, the end of an individual plan, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and other similar circumstances.

Note: Voluntarily ending coverage, including failing to pay premiums, or losing coverage that doesn’t qualify as minimum essential coverage doesn’t make you eligible for a special enrollment period.

If you qualify, there are two types of coverage available:

-Traditional PPO health plan

-If you’re looking for a plan with options, you can save money by choosing a plan that      offers the balance of premium, coverage, and deductible that’s right for you

– High-deductible health plan

-If you are relatively health and your expected medical costs are low, you can reduce      your monthly premiums significantly by choosing this plan

Professional Insurance Programs can help you decide what to do in the event you are between coverages. Should you be in this situation, call us today to prepare for the unexpected.




Info: WPS