Ask MetaFilter questions tagged with insurance and cobra

What are my options for insurance?

suncoursing — Wed, 15 Jul 2009 15:39:18 -0800

What are my options for insurance? I'm starting grad school this fall in Texas, after a few years at a startup. If I were an RA or a TA, I'd automatically be enrolled in the staff insurance plan, but I'm not eligible for that because I'm on a fellowship. I can keep my current insurance through COBRA but, at $600/month, it's a bit expensive. The plan is really nice (no co-pay for a lot of things, $200 annual deductible and maximum out of pocket, no maximum benefit for health or perscriptions, etc.), but it's way beyond anything I need.

The student insurance plan is ~ $160/month, but it has a maximum benefit of $100k. I could handle a plan with a $100k deductible, but $100k maximum benefit means it would only cover relatively minor problems that I could afford without insurance, leaving me with most of the bill for anything catastrophic. Maybe there's something I don't understand about insurance, but this plan seems completely pointless. There's an option to increase the maximum benefit to $500k for an extra fee, but that's still an order of magnitude lower than the maximum benefit for the BCBS plans I've looked at.

BlueCross BlueShield of Texas has various plans ranging from $40/month to $200/month. The $160/month plans look much better than the student insurance plan, and if I'm willing to take a $10k deductible, I can get away with only paying $40/month. If I don't have a pre-existing condition, is there any reason I should prefer group coverage to individual insurance? Are there other insurance providers I should be looking at? I found this list (http://www.tdi.state.tx.us/health/lhiah_lst_incl.html) through a previous post, but since I know absolutely nothing about any of these companies, I might as well go with BCBS if I'm just going to randomly pick a company off that list.

So my options are (roughly in order of preference):
1. BCBS insurance. Only $40/month!
2. Defer my fellowship for a semester, get an RA or a TA, and then pay $300/month to get the staff insurance through COBRA.
3. COBRA. $600/month.
4. ???. Is there something I could do that I don't know about?
5. No insurance
6. Student insurance.

Other than the large deductable, is there any reason I wouldn't want option 1?

Also, do I actually need dental insurance? It seems like insurance only ever covers half the cost anyway, and I doubt anything really horrific will happen if I skip getting a cleaning for a year.

Have we really lost our coverage?

xenophile — Wed, 17 Jun 2009 08:19:55 -0800

Help! My COBRA health insurance ended recently for a sketchy reason and I don't know how to get any answers and I need health care. I live in Nevada. Our state has few options for health insurance. Individual premiums are sky-high and are routinely denied for pre-existing conditions. When my spouse got laid off in December, we signed up for COBRA. Every month we paid his old company for the policy. A week ago when he went to drop off the check there, he found that the company was in the process of being closed. The HR person there told him to pay our insurance company, Anthem, directly for the COBRA premium. He called Anthem and they told him the policy was closed because the company went out of business and the person at Anthem tried to get him to buy an individual policy instead. We tried that route before, but he was denied an individual policy due to pre-existing conditions. We are spinning our wheels trying to figure out what to do. Meanwhile, a family friend said that by law, we are entitled to COBRA for a certain period -- 18 months, I think -- regardless of whether the company went out of business or not. But I can't find any info out about this online. Can anyone please help clear this up ASAP as we are both dealing with some health problems and I do not have insurance from work? Thanks!

How to appeal termination of COBRA benefits?

Macbeth123 — Sun, 05 Apr 2009 22:43:21 -0800

The company that administers my COBRA benefits terminated me because, they said, of an NSF check, which my bank had told me would clear. But it didn't because the check was put thru literally hours before a hold on a $500 check was released. Apparently the bank rep was figuring that either A) the bank would pay the check (they have before) or B) the hold release would happen before the check came thru. My cyber-statement even shows that the check was paid; then the next day it was sent back. (So when I checked my cyber-statement to confirm the info from the phone rep, the check was shown as having been pd.) Q 1) How and to whom do I appeal? Q 2) Is it worth the effort?

Will the Stimulus' "Second Chance" COBRA Election Period Cover Those Who Elected But Didn't Pay?

WCityMike — Wed, 11 Mar 2009 15:37:33 -0800

The American Recovery & Reinvestment Act helps unemployed people with their COBRA payments in two ways: it subsidizes 65% of their payments, and because this lower price makes it affordable for many who couldn't before, it allows people who didn't elect for COBRA the first time a second chance to elect for coverage. I was laid off on October 24, and I did elect for coverage on January 28. But I haven't paid yet. The grace period for payment ends in a few days, on Saturday — it has to either be paid online or postmarked by then. If I were to not pay, would I be given the same second chance as those who didn't elect the first time around — the difference being that I would have elected, but not paid? It's a substantial financial difference for me. A little bit more inside. The matter is slightly complicated in that the administrator of my ex-employer's COBRA program, ADP, hasn't yet changed its balances to reflect the government's 65% subsidy. They require I go retroactively back to when I lost my insurance. As such, for four months of health insurance (12/1-3/31), I face a balance due of about $2,000 — instead of the $700 due that a 65% subsidy would have left. Once things are set up — which the customer service representative I spoke to on the phone implied might be as far off as mid-April — any excess monies will either become a credit towards future payments, or will be paid back to me.

So, I'm faced with two choices at this moment.

I can pay the amount due of about $2,000. At the moment, this reflects four months' COBRA payment. Once the subsidy clears, I'll presumably either be refunded the difference or be given, if I'm doing the math right, about seven months' prepayment credit on my account. Personally, I anticipate that they would choose to make it a "credit," so that the money stays in their coffers (never expect a company of any sort to willingly part with money currently in its coffers during a severe economic recession), and so this would mean $2,000 out of my pocket and not returning to it any time soon. It's something I'm fortunately capable at the moment of very reluctantly doing (thank God), but it's very much not an optimal situation and might cause problems down the road, depending on length of unemployment. In this sort of situation and economy, I'd much rather hold on to ever shekel I possibly can.

Or, I could not pay the amount due. This would be the preferred option if I can be near-certain that I'll be eligible for this "second chance" program. I've confirmed that those people who start COBRA insurance under this "second chance" program will not have to worry about breaks in coverage making them vulnerable for pre-existing condition clauses at their next employer (knock on wood), so that's not a worry. And I only had minor medical expenses these past few months. What alarms me about this choice is should I not be eligible for the "second chance" program — because of that difference, where I did elect but didn't pay — then not paying by this Saturday will essentially mean I forfeit my chance to be covered under COBRA, which not only leaves me uninsured, it also leaves me vulnerable to that awful pre-existing conditions clause which would let my next medical insurer exclude anything for which I had been taking prescriptions, etc. for up to ... I believe for up to a year. At least six months.

Call ADP, you suggest? Already done. Call my Congresswoman's office, you suggest? Already done. Since this evidently was first given to insurance companies on March 1, neither they nor the Department of Labor (whom a phone worker at my Congresswoman's office followed up with) seem to be able to give me a straight answer yet, certainly not before my due date.

I would rather take a bad financial hit now than risk the loss of insurance coverage and exposure to the pre-existing conditions clause, which I think would, simply playing the numbers, offer greater financial liability over the course of that period of exclusion of pre-existing conditions.

I figured I would write this up as an Ask Mefi question on the off-chance that one of the farflung outreaches of the hivemind might have the expertise to wisely advise on this case, enough so that I could make a more educated decision. (The people I spoke with at ADP and at my Congresswoman's office were certainly nice, but I don't believe they were high-level experts, either.) I'm not sure it's likely, but it's worth a Hail Mary play.

Thanks ...

Cobra termination

TigerCrane — Fri, 18 Apr 2008 09:41:22 -0800

I missed a Cobra Payment and they terminated me. How can I appeal their decision? I screwed up, got confused and missed a COBRA payment. They have terminated me as of Feb 29. They tell me that I can write an appeal letter. This will take fourteen days. Can anybody give me some advise as to what to say int the appeal letter?

If it makes a difference, I have bipolar disorder, and have recieved disability. I believe I am still officially disabled.

If I cannot get COBRA back, do I have any other options? My pre-existing condition (bipolar disorder) makes it impossible to buy regular insurance. Now that I have been cancelled due to non-payment, I no longer qualify for HIPAA. What are my options?

Job loss and FMLA

tickettrader — Mon, 10 Mar 2008 22:00:59 -0800

My job is scheduled for termination at the end of the month. My wife is pregnant and could possibly be placed on bedrest about the same time. If I apply for FMLA before my termination date, would my employer have to honor my claim? My employer is unaware of the pregnancy AND I'm only speculating that bedrest could be ordered. Why do I care? If I don't find a new job within the company before my termination date, I'm looking at an additional $900/month in COBRA payments for the 12 weeks of FMLA.

Additional Information:

US Dept of Labor Site

I barely know my boss and he works at a different location.

It is a very large US corporation.

My entire department is being shut down so my job loss is not due to my personal performance - at least I hope.

COBRA vs. out-of-pocket group insurance?

ahimsa — Mon, 14 Jan 2008 16:40:36 -0800

I left my prior job in December and was hired by a temp agency. The agency offers an out-of-pocket health insurance plan. Does this mean I can't opt to continue my old coverage with COBRA instead? Does the fact that my temp agency offers a basic health insurance group plan, though they don't put any money toward it, mean that I am not eligible for COBRA?

The CORBA information my old company sent me says:
"Continued coverage will end for an electing individual on the occurance of any of the following:...
* The date on which the electing individual becomes covered under any other group health plan (as long as the new plan contains no restrictions on coverage for pre-existing conditions which affect the electing individual) after COBRA is elected;"

and
"Under COBRA, your right to continuation of coverage terminates if you become covered by another employer's group plan that does not limit or exclude coverage for your pre-existing conditions."

and on the form:
"Please answer the following questions:
Are you covered under another health plan? YES NO"

I'd prefer to opt for COBRA rather than the health insurance through my temp agency, because (1) I think the plan is better and (2) I think I'd have a gap in coverage because there was a week between the two jobs.

But does the availability of this out-of-pocket group insurance mean I'm no longer eligible for COBRA? Or do I need to buy a month's worth of COBRA coverage to close the gap and also get the new employer's oop insurance plan from then on?

Thanks in advance!!

Should I keep COBRA or try another health insurance provider if I'm moving to a new state and staying freelance?

waxpancake — Sat, 01 Dec 2007 16:28:55 -0800

I recently left my job at Yahoo! in Northern California and am relocating to Portland, Oregon to try my hand at self-employment. Extending my existing medical coverage with COBRA will cost me, my wife, and our three-year-old son $1200/month, which seems absolutely insane. Please help me understand the risks or consequences of waiving COBRA and getting new a new insurance plan. Continuing my Aetna PPO option through COBRA will cost me more than double every other quote listed on eHealthInsurance in Oregon for our family, even for those plans that appear to be comparable. (My existing plan has a $750 annual deductible, $2,750 maximum out-of-pocket, and $15 co-pay for office visits and preventive care with no deductible.)

What's so great about COBRA that it costs more than double everything else? Am I going to screwed with some sort of pre-existing condition nonsense by not continuing coverage from my previous employer? What are the risks by giving up COBRA? Plus, will I even be able to use COBRA if I'm moving from California to Oregon? (Aetna doesn't appear to offer individual coverage in Oregon, so is every doctor out-of-network?)

And finally, is there anything I should look out for when buying through eHealthInsurance? If anyone has specific recommendations for Oregon providers, that would be wonderful.

Travelers Insurance vs. COBRA

picklebird — Wed, 14 Nov 2007 15:31:22 -0800

Can you buy travelers/vacation insurance for a domestic (within the US) trip? Is it dangerous to have traveler's insurance and not traditional health insurance for one month? We leave our jobs November 30. We will be spending the month of December, unemployed, staying at the family vacation house in Vermont. We will be skiing and other potentially dangerous activities. We begin working in Montreal January 1. We could get COBRA coverage from work to the tune of $850. I was wondering if we could just buy a month's worth of travelers insurance instead (with sufficient health/medical coverage). It would save us a good deal of money. Is there something I'm missing?

Is COBRA of use to me?

Anonymous — Mon, 21 Aug 2006 19:38:10 -0800

I'm about to be divorced with no insurance. I have insurance right now through my wife. In other words, I'm on her insurance through her company. Of course, the divorce will change that.

My question is in regards to COBRA. Is is anything that I can use? Or, since it's not my policy, is it of no good to me, in which case I need to go ahead and find a personal policy.

I guess, thought I've read a lot, I still don't have a good grip on COBRA. Thanks in advance.

COBRA across state lines

jimmy0x52 — Mon, 24 Jul 2006 08:57:28 -0800

COBRAFilter: I'm quitting Thursday and moving out of state. Can I still use COBRA? COBRA allows you to keep your health plan(s) - but - most insurance is in a specific state. I.e. when I move to Texas from Arizona, can I still get COBRA that works in Texas or am I SOL?

My company currently resides in FL and I work in AZ as a contractor for a client so I know that they had to find difference insurance for me in AZ than the FL people.

Insurance flawed?

Sinner — Thu, 15 Jun 2006 19:33:15 -0800

If the (small) company I work for goes bankrupt, am I still eligible for COBRA, or is COBRA predicated on the continued existence of the company? I live in California.

Last minute COBRA

jclovebrew — Thu, 16 Mar 2006 09:34:14 -0800

Last minute COBRA coverage. A what-if scenario.. Let's say you're out of a job and are eligible for COBRA to continue your health insurance. As I understand it, the coverage is retroactive back until your original insurance ended. So if you wait, say, 3 months before signing up, you would have to "backpay" all three months.

So would the following be valid and legal:
Do not sign up for COBRA. Pay for doctor and/or medication out of pocket. If something really bad was to happen, where the bills amount to the thousands or tens of thousands of dollars, only then fill out the paperwork and pay for all the months in between, in order to have the recent "something really bad" event get covered.

Some other details/assumptions -
- There's a deadline to how long you can wait before signing on for COBRA. I think it's 2-3 months. So there's a fixed time-frame here.
- The assumption is that I'll be back in a new job with health benefits in 2-3 months time.
- The extent of my medical bills is about $15-30/month for an asthma inhaler, so it's hard to justify paying a hefty sum of money in order to effecitvely get a small discount on my inhaler.

You would think that COBRA and/or the insurance carriers would have safe-guards against people doing exactly what I describe. So does anybody have a good understanding of this and can explain to me why this may or may not be a really bad idea.

How can I find health coverage for my family?

jasonlatshaw — Thu, 10 Nov 2005 21:21:15 -0800

I was laid off. COBRA is running out. How do I best acquire new health care coverage for my family when my wife is in much needed therapy and taking expensive medication? I was laid off from my previous job in September of 2004, and have continued my medical coverage by paying out of pocket using COBRA ($973/month rising to $1200 in January. .. ouch). It runs out in March of 2006, and I'm working to get new medical insurance in place. My real concern is that my wife is undergoing vital mental therapy and taking prescription medication while working through a diagnosed disorder. I am fearful that no new plan will cover this, as they will term it a "pre-existing condition," and we cannot afford the costs of the treatments out of pocket. I am currently working freelance and doing well enough to not want to get a corporate job unless I have to. Plus I'm hopefully getting into a Graduate School at UCLA, starting in September of 2006. I called my current provider today and they told me once COBRA runs out it's over, no extensions are possible with them as an individual. So I now know I have to go to another health plan provider. Does anyone know what my options are?

Help me better understand COBRA and HIPAA

weston — Thu, 27 Oct 2005 23:43:41 -0800

COBRA/HIPAA: Help me understand how these health insurance laws might apply in several employer-leaving or life-changing events. (1) Someone I know was recently fired due to mental health issues. They did affect job performance, and weirded some coworkers out, and also led to some behavior that could be considered mild sexual harrasment. As far as I know, the weirding people out and somewhat inadequate performance were the only official reasons given for firing. Is he eligible for COBRA?

(2) Someone else I know is considering leaving their employer. My understanding is that if they leave voluntarily, they're eligible for COBRA if they apply within 30 days. Are there any pitfalls here, other than bearing the full cost of the group premium? And, in order to help control premium costs, does COBRA coverage allow for adjusting deductibles and limits?

(3) Another person has private insurance, has been diagnosed with cancer, and wants to move back with family in another state -- where their current insurer does not provide. Obviously the cancer makes her largely uninsurable. Does HIPAA do anything to help?

What to do when COBRA health insurance runs out.

pieoverdone — Mon, 10 Jan 2005 03:21:55 -0800

My COBRA runs out tomorrow. I've applied to a private carrier and was declined already. I was under the impression that if there wasn't a 63 day gap in coverage, they had to insure me. [mi] I've applied with another carrier already. If they decline me too, can I appeal the first one? Can I appeal the second one? Has anyone ever done that and what was the best way? I'm just looking for a high deductible plan with either mental health coverage included or a rider I can add to it. I don't want to discuss my medical history, albeit it's nothing salacious; I just want to know what resources I have to get insurance, now that I what I thought was the correct procedure is wrong

I am employed, but I'm a contractor. So no benefits for me.

Insurance continuation question

hindmost — Sun, 26 Dec 2004 17:15:34 -0800

Insurance continuation question: You are laid off of work and go onto COBRA insurance. You get hired for another job that comes with health coverage and start work on the 4th of the month. If you do not pay your COBRA payment for that month, do you have a lapse in coverage for 4 days? I have tried googling but the fact that the original company is a Delaware corporation which operates in California is confounding my ability to detangle the mess, especially as the deadline for COBRA payments for a given month is on the 5th of the month.

Supplemental Mental Health Insurance in the U.S.

Anonymous — Sun, 19 Dec 2004 18:09:27 -0800

I am in search of supplemental mental health insurance (in the US). Does such a thing exist? I'm a full-time grad student about to lose my awesome COBRA benefits from my past job. I'm going on to my husband's plan, which has crappy mental health coverage (only 20 therapist visits a year vs. 45 with my last insurance). I need weekly visits, but there's no way to change the plan. I've googled for supplemental health insurance, but I mostly get sites for those on Medicare. I've checked several major insurance companies, but none have any specifics about their mental health coverage. Has anyone else dealt with this situation? Perhaps someone who works in the insurance industry can point me in the right direction?

Go away from the light!

mookieproof — Thu, 30 Sep 2004 12:30:59 -0800

Catastrophic health insurance (in the US): I've just been laid off and am losing health care benefits. The COBRA premiums are insane--I'm looking for something cheap that will cover near-death experiences. (I will turn to the bottle for any minor ailments.) Anyone have any advice or plan suggestions?

When my insurance (COBRA) ends in March, what can I do?

konolia — Sat, 13 Dec 2003 10:45:31 -0800

When my insurance (COBRA) ends in March, what can I do? Private insurance is prohibitively expensive, and chances are with my preexisting health problems I may not be able to get insurance at all. Worst part is my monthly prescriptions are extremely expensive-we are talking the price of a car payment here, if not more.
Any suggestions, besides moving to Canada?