The vast majority of companies which provide group health insurance cover for their employees are subject to the provisions of COBRA which, in certain circumstances, can cover former employees beyond the normal period and for up to 36 months.
In general terms COBRA will protect individuals from losing their health insurance benefits along with their employment but it should be understood that it is designed purely as a temporary measure to help people through what might otherwise be a difficult period. That said, the act does not provide cover in all circumstances and some employees will find that they do not qualify for cover when their employment ceases. People in an employer's scheme should therefore check with their employer, who should be conversant with the law and able to advise them accordingly.
In effect the law extends an employees right to purchase health cover for himself and his family (as long as they were previously covered) from his former employer at the same rate that applies to employees currently in the scheme. The employee will however have to meet any contribution previously made on his behalf by the employer and may also have to pay an administrative surcharge, which is typically two percent.
One important provision under COBRA is that it does not simply apply in cases where an employee loses his job, but can also come into play when an employee would otherwise lose his health cover because of a change in employment status. This might for example occur when an employee's hours are reduced or when an employee loses entitlement as the result of a divorce.
An employee opting for cover under COBRA will normally be eligible for cover for the period specified in the act, although entitlement will be lost if the holder chooses to purchase an individual health insurance policy or receives cover under another group scheme.
Coverage under COBRA is the same as that provided during employment and so the holder does not have to worry about a change in the level of cover which he or she is receiving. The only change as far as the holder is concerned lies in the responsibility for meeting monthly premium payments. However, it is important to note that there could be a change in the level of benefit if the holder's former employer changes group plans.
COBRA clearly provides extremely valuable protection for employees but it must be understood that this protection is purely temporary in nature and that cover will cease at the end of 18, or in some cases 36, months.
There is one final and very important thing which employees should bear in mind.
Because COBRA coverage is not simply temporary but is also non-renewable, problems may arise if you fall ill during the period of cover and are diagnosed with a serious or chronic condition. Such an event may make it difficult, or in some cases impossible, for you to arrange further cover when your COBRA cover expires. For this reason, it is wise to look on COBRA cover very much as an 'emergency' measure and to take steps to organize ongoing health insurance cover as soon as you are in a position to do so.
Health Insurance And Dental
Hundred of us fall victim to medical health insurance fraud every day and the problem for most of us is that it can be very difficult to spot until it is too late. In most cases it is not until you come to make a claim which is denied that you discover that you have joined the growing list of people who have been victims of this particularly nasty form of fraud.
One of the problems with health insurance fraud is that there are many different forms of fraud perpetrated today and some of these are very cleverly carried out and extremely difficult to spot. There are however a number of things that you can do to help protect yourself.
First, you should always be wary of any health insurance plan which offers you excellent coverage at a very low cost. Medical bills have been rising consistently for some considerable time now and health insurance, in whatever form you purchase it, is not a cheap item. So, if you are offered a plan at a price which seems too good to be true then the chances are that it is not true.
Second, you should be especially suspicious of unsolicited mail which offers you discounted health insurance and your suspicions should be heightened if this offer comes from a company whose name you do not recognize. Fraudsters are especially adept at using names which closely resemble well known household names but which, on close inspection, are found to be spelt slightly differently. If you are not sure about the company but feel that it might be genuine then check with your State Insurance Commission to see if they are aware of the company and, more importantly, have licensed it to sell insurance in your state.
Thirdly, if you receive an offer which appears to be genuine you should read through it in its entirety and pay close attention to any fine print. Even if the offer is genuine, it is the fine print which covers such things as exclusions, which may transform an apparently good offer into a very costly one.
Forth, if a salesperson calls with an offer and asks you either to pay in cash or to pay the full amount of any premium up front then you this is almost certainly a case of fraud.
These are just a few of the steps that you can take to protect yourself against medical health insurance fraud. Perhaps the best answer however lies in only ever purchasing a health insurance plan from a well established and reputable company with a sound track record.
Remember too that there is perhaps nothing better than a personal recommendation from somebody you know and trust. So, if you have a friend or family member who has a plan with a particular company and has had a good experience of dealing with that company, including making claims against their plan, then this is one of the best places to start your own search for sound health insurance.
Both Donald Saunders & Health Insurance are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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