Upmc Health Insurance
COBRA — the most familiar option
With the unemployment rate in Blair County at 8 percent, many people who have lost their jobs are facing the dilemma of finding health insurance coverage.
Perhaps the most familiar option is COBRA – the Consolidated Omnibus Budget Reconciliation Act of 1985. COBRA allows individuals to carry health coverage from a previous job for a limited time at their own expense.
As part of the stimulus package passed by Congress, a person’s former employer may qualify for a 65 percent subsidy toward the premiums for up to nine months.
Right now, COBRA may be the best option, said Steve Trattner, president and chief marketing officer of Cinergy Health and an industry expert on healthcare issues.
“COBRA is the best option for the first nine months [after losing a job] because 65 percent of it is paid for by the employer,” said Bonnie Hand, president of Blair Insurance Services Inc., Altoona. “After the first nine months, you can stay on for another nine months and pay the full cost. After 18 months, you are required to get an individual plan.”
Some people may prefer an individual plan, which can be designed around specific needs.
People need to consider many things when choosing an individual plan such as what medical services are they most likely to use; if their medical providers are in the plan’s network and if the plan will cover any pre-existing medical conditions, Trattner said.
For a healthy person, an individual plan is about $100 a month, but getting such a plan is not always possible, said Brian Brumbaugh, chief executive officer of Preferred Benefit Specialists, Altoona.
“The majority are medically underwritten, which means if you have medical conditions or are on medications they … charge you above the base rate. The conditions determine how much more they are going to charge you. You may get denied if you have too many problems, if you are too much of a risk, ” Brumbaugh said.
Another option is a short-term medical plan, typically designed for six to 12 months of coverage.
“As long as you pay the premium they can’t cancel the coverage on you,” said Paul Querry, an agent for Warren A. Gingrich Agency, Altoona. “Normally they are less expensive. The problem [is] they are medically underwritten, and you can be turned down for the coverage.”
Brumbaugh noted the short-term plan is typically not a comprehensive plan but can help to bridge the gap until a person gets a new job.
Hand said short-term plans can be obtained quickly. One drawback is they don’t cover anything the person has been treated for over the previous 12 months.
“Short term medical [plans] can give the traditional coverage you expect from a major medical plan, but with premiums that are much less than traditional major medical plans since the insurance company won’t have to keep you on the plan as you age and develop new medical conditions,” Trattner said. “However, at the end of 12 months, your plan will expire, and you will need to re-apply if you still need it. That means the pre-existing waiting period starts all over again. Some plans can waive this if you want to accept a less comprehensive plan.”
Insurance experts offer several tips for those trying to find the right plan.
Querry suggested staying with a well-known insurance provider, such as Highmark Blue Cross/Blue Shield, UPMC, Geisinger or HealthAmerica.
Hand said people need to buy from a reputable company and be sure to know what is covered before signing up.
She also recommended opting for a high deductible to reduce the cost.
“Take the highest deductible you can afford. The higher the deductible, the lower the cost,” Hand said. “It is better to have some coverage rather than none at all.”
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