Insurance COBRA etc...
Looking at all possibilites here, including the high likelihood of DH being laid off I have no idea how much COBRA will cost, but I'm betting it will be more than our unemployment check and mortgage combined! As someone with a CA history, there is no other option, is there? An individual plan would consider CA pre-existing and not-coverable, right? We curently have the "cadillac PPO plan" that is offered - is it possible to switch to a different employer-offered plan (Kaiser/HMO) so the COBRA rate would be lower? Or is open enrollment the *only* time you can change...
The "what if's" here are absolutely terrifying...DH has been laid off before and always had a new job within 2 weeks - the situation now is just that much more dire...and the thought of making ends meet for an extended period of time is worrisome...but going w/o continuous group coverage jeapordizes future cancer coverage, which could financially ruin us down the road (even if we are able to ride out the current storm...) I'm guessing COBRA would cost upwards of 2K/month for our family of 5??
I have an interview tomorrow for a p/t job - but no bennies....Layoff will be in March - what do we do to prepare now in case we are affected? DH has been job hunting since Nov. (bad vibe about viability of the company) - but there is *nothing* out there. He is an expereinced electrical engineer. We live in CA.
Thanks for any ideas!
M.
Comments
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I had to do COBRA once and it's expensive. I'm not an expert by any means, but it's my understanding that you have to be insured without a lapse of coverage or it might be 30 days of coverage. If this is true, you should be able to get a short term insurance plan until your husband is employed again. I'm guessing it will probably be as much as COBRA. Pre-existing illness is something I think about and worry about all the time. If I'm going to get a new job, insurance is my top priority.
These are scary times but I believe things will always work out. Sad thing is, your not alone. So many losing jobs and being forced into this situation right now. Hugs to you and praying it will all work out.
Achi
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How expensive COBRA feels depends on whether your employer subsidized your group coverage. If it wasn't subsidized, then COBRA won't feel all that expensive...your former employer/insurer can charge you up to 102% of the cost of the coverage (the extra 2% is for administrative costs).
However if employee health insurance was heavily subsidized it will feel VERY expensive, since instead of the subsidized cost, you'll be paying both that, the subsidy amount your employer formerly paid for your insurance, plus the administrative 2%.
Check your health insurance plan doc, which will describe "changes in circumstance" which will allow you to make new health care elections. That's where you will find out if you can choose a cheaper "option" if your husband is laid off.
Separately, since you're in California, take a look at this page for information on both Federal COBRA & Cal-COBRA. You'll see that there is a toll-free help center number on that page as well.
I hope it doesn't happen. Hang in there!
LisaAlissa
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When I took COBRA a few years ago I did have a choice of plans (HMO's) and opted for medical coverage only - no prescriptions, vision, or dental. At the time the cost was about $300. monthly. If you can take the option of medical only the cost will definitely be less, as well if you can downgrade to a HMO. The HR/benefits dept of the company can provide you with the information/prices, etc. 2K per month sounds excessive (even in these times) and probably the cost will be below 1K per month.
It is best to try to go the COBRA route since you have a pre-existing condition and getting other insurance could be much more money. Do check your state's webiste for medical insurance info.
You may want to consider not getting the prescriptions included to save you money as there are many free or low cost prescription programs available.
Best of luck to you,
Jelly
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Another thought is to ck with an ins. person and see what BCBS or other coverage would be.
I paid for full coverage and meds after my dh went on Medicare and I no longer had a group policy. I paid 2400 a month for ME. I did smoke and am older with the bc hx. Had a small co-pay etc. Don't let that scare you tho. I chose to get meds covered for me for fear of recurrance and the need for chemo, etc. ( I declined chemo on the original dx) Figured that all that money was actually cheaper if I had to get chemo and all the meds for SE's. I could have easily run up 100,000 in a couple of months on meds alone.
I've often told people that the 31 days you have as a grace period between coverage goes really fast! If you have Some kind of coverage between group policies, etc, you cannot be hit with pre existing.
If necessary, I'd even borrow money to cover it -- sad to say.
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What state are you in? I am a licensed Health & Life specialist with an insurance agent in Georgia. Georgia law says that if you leave your group coverage you can convert it to an individual policy IF you do it within 30 days. I do not know the laws of other states so I would check with your state insurance commission office.
We went through my husband being laid off last year with a major national company. No one told us about this law until I went to get my license and I learned about it in class. The agent that I work for didn't even know about it. What we ended up doing was to convert my husband & children to an individual plan and left me on the COBRA until his new insurance kicked in. My individual COBRA was almost the same amount as the policy for hubby & kids. Combined we ended up paying about $700 a month for all health coverage. COBRA was $1500 a month and that was removing dental & vision plans!!!
Please feel free to PM me if I can help you in any way. My cancer journey is why I got in to the insurance business.
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In Illinois...you need get a "certificate of coverage" from your present group ins...if your hubby gets another job that has group insurance ...they will cover you. One alternative..in Illinois we have up to 60 days to notify the group ins. co whether we want to pay COBRA or not. What alot of people here do is wait to see if they have medical bills during that time...if not they just pick up the new group and thats it..but if you have large med bills b4 your new ins kicks in...then just pay the COBRA for a month or 2. Hope this isnt too confusing..hugs, Mazy
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Thank you so much everyone for your input! It seems crazy but policies seem to really vary from state to state! I like the concept of going COBRA for me, and buying an individual plan for the rest of my "healthy" family - I need to look into if that is possible - since I am not the employee! We would also forgo dental/vision/Rx coverage. I had DCIS and a double MX, so I am not on any maintenance meds...we realize the potential severity of this and will be willing to borrow/tap into our HELOC to pay the premium if need be!
Also, I already work p/t, but I am looking into possibly finding something p/t that offers benefits (I know Starbucks and Trader Joe's do - not sure if they are even hiring...) - it would be worth working 20 hours @ min wage to get the coverage!
Hopefully if he is let go, we only have to deal with this for a short period of time - but no one knows what will happen in this downturn...
Thanks again!
Mary
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It does differ by state, and the size of the company that you are employed by, so definitely check the links someone provided you with above.I had to take COBRA for a short time after cancer, and I worked for a tremendous company with over 3000 employees. My COBRA was $338 a month, and the monthly payment that you pay is tax deductible.
NOW-- I've had to take COBRA again, and it's a whole new story. I worked for a very small company, and my monthly payment is $600, (not to mention the SOB's the used to employ me, are charging me a $12 a month processing fee, which by law, they can choose to waive, and even after I asked them to, they declined... I know karma will get them some day)
For me, in the state of NY, you have 63 days where you can go uncovered, before anything would become a pre-existing condition. Also, there's a program called NY Cares, which I'm sure I could apply for, but for me, I'd rather go totally broke paying this COBRA, having the incredible health coverage that I have, rather then take some terrible HMO, and lose every doctor that I trust and love.
I know the $600 will be tax deductible for me next yr, and that will be a huge return. Not that that makes me sleep better at night, but I've only been on this COBRA for two months, and I'm hoping to have a new job with benefits soon. This economy is crushing everyone in its destructive path.
A lot of companies like grocery stores, and Starbucks offer benefits to part time employees as long as you work 31.5 hours per week. Some companies, will only offer benefits to P/T employees after one year of service.
I get the MAX from unemployment, and two weeks go right to my COBRA... you can imagine that there isn't much left for anything else, and we've made some really tough choices like canceling our dream wedding...
I went to the bookstore to find books on the great depression, and read the stories of people who struggled through, and what they did to get by, and I realize that I am far better off then any of those people were, but it's all still really scary.
Sorry for my ramble-- but I just wanted to say hang in there. Things have to turn around for all of us soon.
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Mary,
There's good news for you in the stimulus package. Just read this on Yahoo.
"Right now, most people working for medium and large employers can continue their coverage for 18 months under the COBRA program when they lose their job. It's expensive, often over $1,000 a month, because they pay the share of premiums once covered by their employer as well as their own share from the old group plan.
Under the stimulus package, the government will pick up 65 percent of the total cost of that premium for the first nine months."
http://news.yahoo.com/s/ap/20090214/ap_on_go_co/stimulus_stakes_who_gets_what
Paying only 35% of the COBRA will make it more affordable for more people and that's a good thing!
Jelly
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Does anyone know how to go about getting the government help for the COBRA? Is there a web site? Do you have to apply for it?
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This is what I read on line:
Premium Assistance. A federal subsidy of up to 65% of the COBRA premium will be available to those individuals who were involuntarily terminated from employment between September 1, 2008 and December 31, 2009 and who are responsible for paying at least 65% of the COBRA premium. This is a temporary provision. Under the House bill, the premium assistance payment will be available for 12 months, whereas under the Senate bill, the premium assistance payment will be available for 9 months. The premium assistance payment will be made to the employer or plan sponsor of the group health plan. Under both the House and Senate bills, the employer or plan sponsor will receive the premium assistance payment first by reducing its remittance of payroll taxes to the federal government and if that is not enough, the employer or plan sponsor will receive the premium assistance payment directly from the Treasury Department or the IRS.
Extension of Coverage Period. The House bill provides that the COBRA continuation period will be permanently extended for individuals who lose health coverage due to termination of employment (other than by reason of gross misconduct) or reduction of hours of employment and who at the date of their loss of health coverage either are (i) age 55 or older or (ii) have completed 10 years of service (with service calculated under the retirement plan rules). The expanded COBRA period starts with the loss of coverage and generally ends on the earlier of: (i) failure to pay premiums; (ii) obtaining coverage under another group health plan; or (iii) becoming Medicare eligible. This extended period applies not only to the former employee but to the former employee's spouse and dependents. COBRA coverage will also end if the employer terminates all group health plans for all employees.If the House provision is enacted, the current 18-month COBRA period will no longer apply for these older or long-service employees. This means that a 30-year old employee with 10 years of service could terminate employment and pay for COBRA continuation coverage for over 35 years until he or she is Medicare eligible. There is no similar COBRA extension in the Senate bill.
So does this mean, that my former employer gets the credit, and is supposed to charge me less per month? I don't get the bill sent to me b/cthaye had a small amount of employees in the company. I have to pay my former employer on the first of the month, every month. I'm so confused. I know I should fall into the group that qualifies for the 65% assistance, but I don't know how to go about getting it.
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My husband was laid off, and we were on Cobra when I was diagnosed. Nice. Our cobra is $1200 a month for the 4 of us - I have started chemo, and really don't think I can shop this now - who would want me on their policy???
I am very excited about the Obama cobra help - although I need to double check my husbands lay off date - it may be 8/30/08 - that would just add to our problems if we just miss the cut off. He negotiated some of the details so I don't know when his actual final date was - the negotiations took a couple of weeks to finalize.
I am thankful that we at least have the cobra, and although it is expensive, it is way cheaper then my current medical bills. They are astounding.
Does anyone know how we go about applying for the cobra help?
Susan
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It looks like the info is supposed to come from your previous employer or the plan administrator by March 1, 2009. (edited)
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My husband was laid off right before Thanksgiving. We had our benefits until 1/2/09. (we live in Illinois) I had until Midnight 3/2/09 (postmarked) to let his former employer know if we were going to elect Cobra. I was planning to have the Cobra just for myself and had my husband and 2 sons set up to go with an individual Humana Health plan. Literally this past Tuesday morning there was an article in the Chicago Tribune talking about the Obama stimulus plan and the changes to Cobra. I called the health insurer from my husband's former company. They said, yes, they were sending out 60 day extensions to people who had not yet elected Cobra. If we qualified, (see below) we would only pay 35% of the costs. The day before I received an email from Humana saying we were all set - I immediately cancelled the plan with them.
Eliglibility : Single - make less than $125,000/yr, Couple - make less than $250,000/yr
By law, when electing cobra, if there are less expensive plans offered, you can switch your election to the less costly plan.
I hope this helps - I know what a huge relief it has been for us knowing that this $$ burden has eased somewhat.
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Catherine now thats what I call change. I'm so glad that those out there will find some relief with COBRA. I had to be on it once and it was so expensive. I heard this was part of the Bill that passed and I'm so glad to see it's actually happening.
Achi
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I'm trying to not get down about all of this, but I contacted my former employer, and they wouldn't give me the name or contact info for the person who handles COBRA, and he wrote me a two line response that said he'd deal with it after his vacation.
I keep telling myself Karma will come back around. Maybe it will rain on his vacation, or the airline will lose his luggage....Okay, I don't really mean that. But I feel like they don't care about helping me out wirth any of this. I went on every government web site I could find, and all I came up with is that the discount gets paid directly to the COBRA plan provider, and in turn they are supposed to charge me less per month. I don't pay my insurance directly- I pay my ex employer...
Hopefully I'll have some answers by next week.
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With this just being passed, do you think people like your employer have been given the information to address this yet? My guess is that if they threw this together so fast that they couldn't even give Congress enough time to READ this bill, then they sure don't even have the beginnings of logistics of how to administer all the requirements down either.
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Beth - who is the insurance carrier through your former employer? They should be the ones handling all of this. Contact them. When you were let go, did you get a letter stating you had x amount of days to reply to the notice as to whether or not you wanted Cobra? PM me if you think I can help or you have any questions.
Catherine
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My son rec'd an email from his former employer's HR dept. they recommended that those on Cobra pay the March payment. They expect the package to come thru and the co. will pay 65% and be reimbursed by the gov't. after that---or at least very soon.
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This is my experience with this Cobra thing: I've been off work since this reoccurrance on 8-3-08, used up all FMLA and now on LOA. During the FMLA period my insurance was paid by my employer (large hospital) just as if I was still on duty. When the FMLA period ran out I had to start paying the COBRA which is 487.00/month and started in Nov 08 but I'm still "on their books" as an employee until April 25th.
The HR rep says after that date they have to legally "separate" me from their company then I'll be eligible for the subsidy but I'll be paying another company (third party payor). The rep said they would notify me by mail regarding the payments and amount but to continue to the sent the 487 until then since if you don't it could mean you lose out big time. So don't miss a payment or send in the decreased amount until they tell you!.
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WAHOOOOOOO!!!!! GREAT NEWS GIRLS!!!! I FINALLY got an email from my ex employers! And the stimulus package has gone through, and my payments have been reduced by 65%!!!!!! Of course, they are still charging me a $12 a month admin fee, which is so disgusting of them, but I can't complain. I am looking at a savings of almost $400 a month!! I can't believe this!!!!
This is a great ending to what started out as a crummy day!!!!
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That is great news!
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Oh, how wonderful!! there is hope for my son, too!!
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Dotti, I finally had to contact my local representative, and make some light threats to get the ball rolling, but now that it is, I can breathe much easier at night!!!!
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Wonderful news!!!!
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Great news, Beth! I am the original poster - and things are looking better here, as well! The layoff will be Thursday - but DH thinks he will *not* be affected this time after all. He is also interviewing for a position in a less-vulnerable department, which would be the best scenario. He also had an interview Friday at another company and he feels it went very well. So with a variety of options on the horizon, I don't feel as frightened of the unemplyment scenario as I was....and the new COBRA stimulus is definitely good news!!
Good health and continuing insurance coverage vibes for all!
Mary
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I have an interview Friday too! So good interview vibes are in the universe!! If I get this job, and the healthcare costs more then the new monthly payment for my COBRA, I will actually continue the COBRA b/c it's a great plan, and then switch after the 9 month stimulus benefit is up.
Looks like things are starting to look up for some of us... AND SPRING IS IN THE AIR!!!!!
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Beth, that is great news again! You deserve it too. I'll keep good thoughts going for this interview.
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Does this cobra stimulus plan apply for us who went out on disablilty? I call my hr person today and she says I don't qualifiy because I wasn't laid off but went out on disablitiy.
Thanks
Denise
I live in California
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You can get more info at www.recovery.gov
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