eHealthInsurance Answers Frequently Asked Questions on Unemployment and Health Insurance Options
Going Without Health Insurance Is Not an Option; eHealthInsurance Encourages Consumers to Research and Understand Their Choices
MOUNTAIN VIEW, CA -- (Marketwire) -- 02/06/09 -- eHealthInsurance, the leading onlinesource of health insurancefor individuals, families and small businesses, today released a list ofanswers to questions frequently asked in its customer care center. Thecustomer care center includes a call center staffed with licensed insuranceagents.
A one percent rise in the unemployment rate is projected to increase thenumber of uninsured Americans by 1.1 million according to data from The Henry J. KaiserFamily Foundation(1). The answers provided can help people makeinformed choices regarding their health insurance coverage if they losetheir jobs. eHealthInsurance has also posted a video on YouTube withanswers to some of these questions, which can be accessed at:http://www.youtube.com/watch?v=MEUZ0Qvbx8k.
Question: If I lose my job, what are my options for health insurance?
-- Explore COBRA first: If you're offered COBRA continuation coverage,learn exactly how much your COBRA premiums will cost each month, andexactly what the benefits are. COBRA insurance often provides verycomprehensive benefits to satisfy a broad audience. Think about whichbenefits you really need. Note that COBRA health insurance can provideimportant protection for people who have pre-existingmedical conditions. These conditions may prevent them from otherwisequalifying for an individually-underwritten health insurance plan.
-- Check your spouse's plan: If you're married and your spouse is employed,check to see if you can get on your spouse's employer's plan. Learn howmuch, if any, the employee share of the premium would increase if you jointhe plan. Some employer-sponsored plans also allow for non-marriedemployees to add a long-term partner to an employer sponsored plan.
-- Explore alternatives to COBRA: If you are in relatively good health anddon't have any pre-existing conditions, you may be able to find lessexpensive options to COBRA by purchasing individual health insurance. Infact, the average COBRA premium costs 60% more than the average premiumsfor comparable individual coverage purchased on-line.(2) It's easy tocompare plans, benefits and prices by calling an independent broker or bygoing online to eHealthInsurance.com to find COBRA insurance alternatives. For more information aboutCOBRA go to eHealth's COBRA Learning Center athttp://www.cobralearning.com.
Question: How do I know if I qualify for COBRA?
Answers: Qualifications for COBRA insurance include voluntary or involuntarytermination of employment (for reasons other than gross misconduct), aswell as reduction in the number of hours of employment. If you elect tomaintain your health insurance benefits through COBRA you'll be required topay the entire premium, plus a 2% administration fee, out of your ownpocket.
You're not eligible for COBRA under the following circumstances:
-- If your employer does not currently offer you health insurance coverage,you're not eligible for COBRA.
-- If your company files for bankruptcy (chapter 11) or shuts downcompletely and therefore offers no group plan, you're not eligible forCOBRA.
-- If you fail to apply for COBRA benefits within 62 days, you will nolonger be eligible for COBRA.
Question: What if I have a pre-existing condition making COBRA my onlyalternative?
-- Get creative: If you're faced with unemployment, get creative. If theplan's primary beneficiary has a pre-existing condition, and needs to stayon COBRA insurance, you may still be able to save money by placingadditional family members on a separate, and potentially less costly,plan. Do the math on separate policies to see if you can't meet yourfamily's medical needs at a lower cost. Again, it's easy to priceindividual and family plans online at eHealthInsurance.com
-- Explore alternative programs: If you absolutely cannot afford COBRA,you're not without hope. The Foundation for Health Coverage Education hasan excellent web site and great resources that can connect you withgovernment programs in your state. That web site ishttp://www.coverageforall.org and the toll-free number for their U.S.Uninsured Help Line is 800-234-1317.
-- Explore short-term coverage: Depending on the degree of yourpre-existing conditions, you may have a better chance at qualifying for ashort-term plan.Short-term health insurance policies typically last forsix months, are often a little more affordable and can be easier to qualifyfor. Short-term coverage has limitations, but provides you with a measure of financial protection in the event of a medical emergency. It's important tonote that ashort-terminsurance plan often does not count as continuation of crediblecoverage and doesn't cover any pre-existing major medical chronicconditions.
Question: How can I find out if I'm healthy enough to qualify for anindividual health insurance plan?
-- Start with a licensed agent: Calling an agent licensed in your state canhelp you figure out if your pre-existing health problems might exclude youfrom qualifying for an individual health insurance policy. Callers intoeHealth's toll-free number, 1-800-977-8860, are able to talk to an agentlicensed in their state, Monday-Friday 5:00am-9:00pm and Saturday-Sunday7:00am-4:00pm Pacific Standard Time. It's important to note that thecarrier, not the agent, makes the decision regarding whether you qualifyfor a particular plan. eHealth's licensed agents, though, may be able toguide you to a carrier that is more likely to cover your condition.
-- Talk to your doctor: Before you decide to apply for a plan online, it'salso a good idea to check with your doctor. Individual plans are subjectto underwriting for pre-existing conditions. You should carefully considerCOBRA coverage if you or a member of your family are currently pregnant,have a pre-existing health condition, are taking prescription medications,or have been declined for private health insurance.
-- Feel free to explore your options: If you're afraid that you will putyour COBRA insurance at risk by applying for another plan, don't be. Otherthan a non-refundable application fee imposed by some carriers, applyingfor an individual or family health insurance plan in order to see if thereare plans that you qualify for, and can afford, will not impact youreligibility for COBRA. Always make sure you fill out an application astruthfully and accurately as possible.
Question: When I consider purchasing an individual health insurance planfor myself or my family, do I have any financial obligations beyond themonthly premium and annual deductible?
Answers: It depends on the plan, but typically....
-- Co-Payments: Some plans include a co-payment, which is typically aspecific flat fee you pay for each medical service, such as $30 for anoffice visit. After the co-payment ismade, the insurance company typically pays the remainder of the coveredmedical charges.
-- Deductibles: Some plans include a deductible,which typically refers to the amount of money you must pay each year beforeyour health insurance plan starts to pay for covered medical expenses.
-- Coinsurance: Some plans include coinsurance.Coinsurance is a cost sharing requirement that makes you responsible forpaying a certain percentage of any costs. The insurance company pays theremaining percentage of the covered medical expenses after your insurancedeductible is met.
-- Out-of-pocket limit: Some plans include an out-of-pocketlimit. Typically, the out-of-pocket limit is the maximum amount youwill pay out of your own pocket for covered medical expenses in a givenyear. The out-of-pocket limit typically includes deductibles andcoinsurance. But, out-of-pocket limits don't typically apply toco-payments.
-- Lifetime maximum: Most plans include a lifetimemaximum. Typically the lifetime maximum is the amount your insuranceplan will pay for covered medical expenses in the course of your lifetime.
-- Exclusions & Limitations: Most health insurance carriers disclose exclusions &limitations of their plans. It is always a good idea to know whatbenefits are limited and which services are excluded on your plan. You willbe obligated to pay for 100% of services that are excluded on your policy.
About eHealth, Inc.:
eHealth, Inc. (NASDAQ: EHTH) is the parent company of eHealthInsurance, thenation's leading online source of health insurance for individuals,families and small businesses. Through the company's website,http://www.ehealthinsurance.com, consumers can get quotes from leadinghealth insurance carriers, compare plans side by side, and apply for andpurchase health insurance. eHealthInsurance offers thousands of healthplans underwritten by more than 180 of the nation's health insurancecompanies. eHealthInsurance is licensed to sell health insurance in all 50states and the District of Columbia. eHealthInsurance and eHealth areregistered trademarks of eHealthInsurance Services, Inc.
(1) The Henry J. Kaiser Family Foundation, New Analysis Shows Effect ofRising Unemployment on Health Coverage, Medicaid and SCHIP Spending andEnrollment, April 28, 2008, http://www.kff.org/medicaid/kcmu042808pkg.cfm
(2) Calculated using average total premium cost for employer-sponsoredhealth insurance coverage reflected in the Henry J. Kaiser Foundation studyEmployee Health Benefits: 2008 Annual Survey(http://ehbs.kff.org/pdf/7790.pdf) plus the standard 2% administration costcharged to most COBRA participants; then compared to average premiums forprivately-purchased individual and family coverage in August 2007 cited byeHealth, Inc. and Forrester Research in The Cost and Benefits of IndividualHealth Insurance Plans: 2008, November, 2008(http://www.ehealthinsurance.com/content/expertcenterNew/eHealthCBreport2008FINAL.pdf).