COBRA Subsidy Q&A: eHealthInsurance Answers Questions Raised During Recent ‘Coping Without COBRA’ Webinar
June 03, 2010 | Consumer Advice
MOUNTAIN VIEW, CA – (June 3, 2010) –Today eHealthInsurance (NASDAQ: EHTH), the leading online source of health insurance for individuals and families, released answers to several key questions asked by attendees of the recent ‘Coping without COBRA’ webinar, which took place May 25, 2010.
To watch video recordings of the Webinar and review related materials, visit the eHealthInsurance Media Center.
The well-attended webinar, co-hosted by eHealthInsurance, the Foundation for Health Coverage Education and Healthcare Blue Book, was designed to address the concerns of current COBRA enrollees who are about to lose their 15-month federal subsidy, as well as others looking for health insurance options beyond COBRA. Specifically, the webinar explored:
- New and existing public health insurance programs that may serve as alternatives to COBRA (video)
- New and existing privately-purchased health insurance products that may serve as alternatives to COBRA (video), and
- Strategies for becoming a smarter consumer of medical care, for those with or without coverage (video)
The following are summary versions of questions raised by attendees of the webinar. While answers were provided to most questioners during the course of the webinar or immediately afterwards, the information contained below may be of interest to many of the millions of COBRA enrollees who may lose their federal subsidy or COBRA coverage in the coming weeks:
The End of COBRA and the Subsidy:
Question: “Can I continue COBRA coverage after the subsidy runs out?”
Answer: Yes, in most cases you can keep COBRA coverage for up to 18 months. The federal COBRA subsidy provided premium assistance to qualifying enrollees for up to 15 months, but you do have the option to continue your COBRA coverage for an additional three months without the subsidy – which covered 65% of your monthly premiums.
In some states, or for persons with qualifying medical disabilities, it may be possible to continue your COBRA coverage beyond the 18-month limit. Depending on your circumstances, you may even qualify for additional financial assistance. To learn more, talk to your former employer’s HR department or benefits administrator, or else contact your state Department of Insurance.
Question: “Will the COBRA subsidy be extended?”
Answer: There are no major legislative efforts underway in Congress to extend the length of the COBRA subsidy beyond 15 months.
Legislation that would extend the eligibility period for the subsidy – allowing a person laid off after June 1, 2010 to qualify for 15 months of premium assistance – has not yet been voted on by Congress.
Question: “Can I convert my COBRA coverage into an individual or family health insurance plan?”
Answer: The health insurance coverage you have through COBRA is the same group health insurance plan sponsored by your former employer, so it can’t be “converted” to an individual or family plan.
However, you may be able to buy an individual or family plan from your current health insurance company or another carrier in your area. It’s possible that purchasing coverage on your own could save you a considerable amount of money on your monthly premiums. A 2009 analysis of COBRA and individual and family health insurance premiums suggests that average monthly premiums for individual and family plans are often less expensive than even subsidized COBRA coverage, though plan benefits may differ in some cases.
In most states, individual and family health insurance is medically underwritten and it’s possible you may be declined for coverage based on your medical history. But if you’re relatively healthy, it’s a good idea to look into the individual and family health insurance options available in your area.
Work with a licensed agent, like eHealthInsurance, that offers a broad selection of plans from top carriers in your area, allowing you to compare rates and benefits and find the best match for your needs and budget.
On Pre-existing Medical Conditions:
Question: “How can I find out if a particular diagnosis will be considered a pre-existing condition and prevent me from being approved for coverage?”
Answer: A good way to find out is to have a conversation with a licensed agent who has addressed this question with a large number of insurance carriers, like the agents at eHealthInsurance.com.
What qualifies as a “pre-existing condition” may differ substantially from one insurance carrier to the next, and from one state to the next. Not all medical diagnoses will result in a declination of coverage, though some are more likely to be problematic than others.
Again, we recommend that you work with a licensed health insurance agent that represents multiple insurers in your area. A licensed agent like eHealthInsurance can help you understand which insurers are more or less likely to offer you coverage based on your personal medical history.
Question: “Is there a ‘statute of limitations’ for pre-existing medical conditions?”
Answer: In most states, unfortunately, the answer is no, though there are a handful of states (including New York, New Jersey and Massachusetts) in which insurers are forbidden to refuse coverage to applicants based on pre-existing medical conditions.
When the final provisions of health reform are enacted in 2014, no one can be refused health insurance because of a pre-existing condition. Until that time, however, it’s still possible that you may be declined coverage for an individual or family health insurance plan based on your medical history.
See the answer to the question above and be sure to work with a licensed agent who can help you understand which insurance carriers are more likely than others to accept you for coverage.
If you find that you cannot qualify for or afford health insurance on your own, please contact the Foundation for Health Coverage Education at 800-234-1317 (or through their website, www.coverageforall.org) to learn more about the government-sponsored health insurance options in your area.
On HIPAA Plans and HIPP:
Question: “Can you explain again about HIPAA plans and what protections HIPAA laws provide?”
Answer: HIPAA (the Health Insurance Portability and Accountability Act of 1996) is a federal law designed to help consumer maintain continuous health insurance coverage if they meet specific criteria. If you can demonstrate that you have maintained coverage under a qualifying major medical health insurance plan with a gap of no more than 62 days, you may be entitled to individual and family health insurance without danger of being declined or delayed coverage for pre-existing medical conditions.
Unfortunately, HIPAA (pronounced “hippa”) plans, as they are generally called, may be more expensive than certain other kinds of individual and family health insurance plans. If you’re coming off of COBRA, you may qualify for HIPAA coverage but the monthly premium you will be required to pay may be no more affordable than COBRA without the federal subsidy.
To learn more about HIPAA and other similar protections and how they may be applied in your case, work with a licensed health insurance agent familiar with the market in your state, or else contact your state Department of Insurance.
Question: “Where can I find HIPAA plans?”
Answer: Generally speaking, HIPAA plans are not marketed directly to the public, though some health insurance companies are required to provide them under certain circumstances. When you apply for a non-HIPAA individual or family health insurance plan, you may be asked certain questions on the application designed to determine your eligibility for HIPAA protection. If you have pre-existing medical conditions that might otherwise have prevented you from obtaining coverage but it is found that you do qualify for HIPAA, the insurance company may offer you HIPAA coverage instead, or refer you to a HIPAA carrier. In some cases, you may have to appeal a declination with the insurance company and demonstrate your eligibility for HIPAA in order to obtain an offer of coverage under a HIPAA plan.
To learn more about HIPAA, download a booklet on the law published by the Department of Health and Human Services here. To make sure that your HIPAA eligibility is respected throughout the application process, be sure to work through a licensed agent like eHealthInsurance when applying for individual or family coverage.
Question: “Is there a limit to how much I can be charged for HIPAA coverage?”
Answer: Possibly. Since health insurance rates are regulated on a state-by-state basis, you may wish to contact your state Department of Insurance for more information. However, since HIPAA plans are generally designed to cover persons who are considered at risk for higher medical costs, HIPAA plans are sometimes more expensive than other individual or family health insurance plans.
Question: “Am I obliged to purchase HIPAA coverage if I qualify for it and don’t want to go uninsured?”
Answer: Thankfully, many people have more options than just HIPAA. While HIPAA offers valuable protections for eligible persons with pre-existing medical conditions, persons who are relatively healthy may be able to find more affordable health insurance alternatives in the general individual and family health insurance market.
Question: “Can you tell me more about HIPP, as an alternative to COBRA?
Answer: HIPP is the acronym for the Health Insurance Premium Payment program (not to be confused with “HIPAA”). HIPP allows people who qualify for Medicaid in their state to continue their current private insurance coverage – including COBRA coverage – and get premium assistance from their state government. HIPP is only available in a few states and each state has its own criteria to determine who qualifies for assistance.
To get more information about the availability of HIPP in your state, or to get help enrolling in HIPP, contact The Foundation for Health Coverage Education (www.coverageforall.org).
Question: “Where can I find reliable resources to help me understand my options after COBRA?”
Answer: Start with the sponsors of the ‘Coping without COBRA’ webinar:
- eHealthInsurance (www.ehealthinsurance.com) offers thousands of health insurance plans from over 180 carriers nationwide and is licensed in all 50 states plus DC. eHealthInsurance allows you to get quotes from a broad selection of individual and family health insurance plans in just seconds. You’ll also be able to compare rates and benefits, read customer reviews, receive advice from licensed agents by phone and apply for coverage online.
- The Foundation for Health Coverage Education (www.coverageforall.org) is a non-profit foundation created to help consumers understand the private and public health insurance options available in their state, and to provide them with the information they need to learn more and enroll for coverage.
- Healthcare Blue Book (www.healthcarebluebook.com) helps empower consumers, both the insured and the uninsured, by identifying average costs for a broad range of medical services in their area, and by providing them with tools to negotiate rates and make the most of their medical care dollars.
eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, the nation's leading online source of health insurance for individuals, families and small businesses. Information and resources are available on various health plans, ranging from individual and family, short-term medical, and Medicare insurance. Consumers can get quotes from leading health insurance carriers, compare plans side by side, and apply for and purchase health insurance. eHealthInsurance is an online marketplace licensed to sell health insurance in all 50 states and the District of Columbia. eHealthInsurance and eHealth are registered trademarks of eHealthInsurance Services, Inc. For more information, see www.ehealthinsurance.com.