Prescription Drug Plans Available in Texas
Insurance Company Name Phone Number Website Address
Advantra RX 1-800-882-3822 www.advantrarx.com
Aetna Life Insurance Company 1-888-224-0989 http://www.aetna.com/
Blue Cross Blue Shield of TX 1-888-579-9373 www.hisc.net/txrx/
CIGNA HealthCare 1-800-735-1459 http://www.cignature-rx.com/
Community Care RX 1-866-684-5353 http://www.communitycarerx.com/
Elder Health Texas, Inc. 1-888-225-0026 http://www.elderhealth.com/
Humana Inc. 1-800-851-1629 http://www.humana-medicare.com/
PacifiCare Life and Health Insurance 1-800-943-0399 http://www.partdandme.com/
Prescription Pathway 1-800-825-8200 http://www.rxpathway.com/
RxAmerican 1-877-279-0370 http://www.meds4medicare.com/
Scott and White Health Plan PDP 1-866-334-3141 http://www.sw.org/
SierraRX 1-866-789-0565 http://www.sierrahealthandlife.com/
SilverScript 1-866-552-6106 http://www.silverscript.com/
Sterling Prescription Drug Plan 1-888-909-1713 http://www.sterlingplans.com/
Texas HealthSpring PDP 1-800-846-2098 http://www.texashealthspring.com/
Unicare 1-866-892-5335 http://www.unicare.com/
United American Insurance Company 1-866-524-4169 http://www.uamedicarepartd.com/
United HealthCare / AARP 1-888-867-5565 http://www.aarpmedicarerx.com/
WellCare 1-888-423-5252 http://www.wellcare.com/
YOURxPLAN 1-800-758-3605 http://www.yourrxplan.com/
February 04, 2006
January 30, 2006
Medicare Part D - Issues
Medicare Part D continues to be a controversy rather than the shot in the arm that it is supposed to be. It continues to be amazing that this is such a complicated area and yet Seniors are supposed to be able to make sense of all of it.
Mr. Joe Paduda's weblog has recent updates on the fall out from the poorly planned administration of Medicare Part D, including the fact that "pharmacies are not able to access eligibility information in government databases through the normal EDI links, requiring the pharmacists to call Medicare where they spend hours on hold. Meanwhile, patients are't getting their drugs." http://www.joepaduda.com/archives/000381.html.
Government agencies are notorious for little or no cooperation with one another. The problem is when individuals have to deal with these inefficiencies and especially when this lack of cooperation and/or expertise impacts one's critical components for living as healthy as possible.
Mr. Joe Paduda's weblog has recent updates on the fall out from the poorly planned administration of Medicare Part D, including the fact that "pharmacies are not able to access eligibility information in government databases through the normal EDI links, requiring the pharmacists to call Medicare where they spend hours on hold. Meanwhile, patients are't getting their drugs." http://www.joepaduda.com/archives/000381.html.
Government agencies are notorious for little or no cooperation with one another. The problem is when individuals have to deal with these inefficiencies and especially when this lack of cooperation and/or expertise impacts one's critical components for living as healthy as possible.
January 23, 2006
Medicare Part D – Making A Decision
Seniors are being asked to choose a drug plan with a dizzying array of information being thrown at them in order to make the choice. The problem is that if they make the incorrect choice, their health could be at risk. If they choose a provider for Medicare Part D that has a formulary that does not include their current prescriptions, then Medicare Part D is not going to save these seniors any money. So what should be done?If you have an older parent or are friends with someone who is considering Medicare Part D it may be a good idea for these older people to have some additional input. Obviously there are older people who have memory problems and are not as capable of filtering through the multitude of plans being offered to them in order to choose the best plan.
Here are the things that will need to be done in order for the choice to be made.
1. Review the current drugs that are being used. Make an all-inclusive list of medicines that are currently being taken. It might be a good idea to speak to the doctors and ask what kind of medicines are likely to be needed in the future given any kind of existing chronic conditions. That way there will be fewer surprises when a new prescription is added.
2. Check the current drug coverage. A letter should have been sent from the insurer stating whether the plan is creditable, meeting Medicare’s minimum requirements. In this case, waiting may be the answer but the letter gives proof that the beneficiary didn’t wait until after coverage was needed to get good drug coverage.
3. The deadline for enrolling in a Part D plan is penalty-free until May 15, 2006. Get all the education before that deadline because once it passes, if there wasn’t a creditable drug plan in place at the time of enrollment, there will be an extra 1% charge on premiums for every month delay in signing up. That can be significant in a very short time frame.
4. Finally, be careful about options before actually making the choice. Find out what changes the employer plans to make should a Part D plan for prescription drugs be chosen. Will it affect current coverage? Some employers may continue to cover medical bills but it is expected that about half will drop retired employees from their insurance plans entirely should the former employees purchase a Part D plan.
Medicare Part D is like any major financial decision in that it should be made with a very clear head and without emotions attached. Choosing the right plan should be based on whether it will save the senior money on the prescription drugs that they take, exactly what it is supposed to do. If the plan doesn’t do that, it doesn’t matter how nice the people who try to sell it are, they aren’t the ones who will pay whatever drugs that won't be covered, the senior will.
Get the information and ask questions, lots of questions. Don’t forget that there are lots of resources out there to help make this decision as painlessly as possible, including Medicare’s website, http://www.medicare.gov/.
January 05, 2006
Economize:
“Synonyms: be economical, be frugal, be prudent, be sparing, conserve, cut back, cut corners, cut down, husband, manage, pinch pennies, retrench, save, scrimp, shepherd, skimp, stint”
Look how many of these synonyms for economize could be considered in a negative connotation. How odd that somehow the frugal individual is frowned upon for their budgetary sense. Perhaps it is a symptom of the throw away society that encourages waste.
In fact, so much waste is accumulated each day that storage facilities are a booming business, necessary to house all of the stuff that Americans can no longer find room for in their homes. So now many of these average citizens scramble to find a storage facility to store all of this unwanted stuff. Therefore they not only have wasted the money on things they don’t use but to add insult to injury, they now have to pay rent to store all of it and it may stay in storage for years.
Television shows on HGTV and The Learning Channel such as “Clean House” and “Mission Organization” highlight the amount of clutter that people generate every week. These shows and others show the must have syndrome that prompts all of the impulse buys for things that have no practical use. Instead the individuals purchasing these things are often deep in debt hoping to purchase more items. Economize and all of its synonyms are not a part of these folks vocabulary.
But changes can be made with just a few adjustments in lifestyle. Before purchasing that knickknack that may seem too cute to resist, stop and think. First, does it go with anything already in the house? If so, does that mean this would be essentially a duplicate of the same thing? If your house were cluttered, this item would be just another piece that needs dusting on a frequent basis. Once you bring these thoughts to the foreground of your consciousness, it may be that looking at the cute knickknack, admiring it and putting it down for someone else to purchase is the way to go. Think of all the money that could be going into a savings account instead.
Economizing doesn’t mean giving up things you need. It means being smarter about what you currently have and using those things before automatically purchasing new things. Do you have things that were purchased and used once before becoming dust collectors? If so, maybe it is time to clean up and get rid of the additional drains. A yard sale is one way to even recoup some of your costs back. If that is too much of an effort, consider giving your unwanted stuff to the local charity. Either way, it is better to get rid of the extra clutter than to rent storage space for it. Then, just think before you buy and you will be on your way to becoming a frugal person.
"It is great wealth to a soul to live frugally with a contented mind."
Lucretius (99BC - 5BC) Roman poet, philosopher.
Look how many of these synonyms for economize could be considered in a negative connotation. How odd that somehow the frugal individual is frowned upon for their budgetary sense. Perhaps it is a symptom of the throw away society that encourages waste.
In fact, so much waste is accumulated each day that storage facilities are a booming business, necessary to house all of the stuff that Americans can no longer find room for in their homes. So now many of these average citizens scramble to find a storage facility to store all of this unwanted stuff. Therefore they not only have wasted the money on things they don’t use but to add insult to injury, they now have to pay rent to store all of it and it may stay in storage for years.
Television shows on HGTV and The Learning Channel such as “Clean House” and “Mission Organization” highlight the amount of clutter that people generate every week. These shows and others show the must have syndrome that prompts all of the impulse buys for things that have no practical use. Instead the individuals purchasing these things are often deep in debt hoping to purchase more items. Economize and all of its synonyms are not a part of these folks vocabulary.
But changes can be made with just a few adjustments in lifestyle. Before purchasing that knickknack that may seem too cute to resist, stop and think. First, does it go with anything already in the house? If so, does that mean this would be essentially a duplicate of the same thing? If your house were cluttered, this item would be just another piece that needs dusting on a frequent basis. Once you bring these thoughts to the foreground of your consciousness, it may be that looking at the cute knickknack, admiring it and putting it down for someone else to purchase is the way to go. Think of all the money that could be going into a savings account instead.
Economizing doesn’t mean giving up things you need. It means being smarter about what you currently have and using those things before automatically purchasing new things. Do you have things that were purchased and used once before becoming dust collectors? If so, maybe it is time to clean up and get rid of the additional drains. A yard sale is one way to even recoup some of your costs back. If that is too much of an effort, consider giving your unwanted stuff to the local charity. Either way, it is better to get rid of the extra clutter than to rent storage space for it. Then, just think before you buy and you will be on your way to becoming a frugal person.
"It is great wealth to a soul to live frugally with a contented mind."
Lucretius (99BC - 5BC) Roman poet, philosopher.
January 04, 2006
COBRA 101
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) signed into law on April 7, 1986. Congress created this law primarily to help individuals retain group health insurance when there was a break in coverage due to such things as unemployment or changes in family status such as divorce.
COBRA is a law that employers must adhere to by offering continuation of group health benefits to individuals who lose coverage as a result of the following qualifying events.
Qualifying Events
Divorce
Legal Separation
Los of dependent child status
Medicare entitlement
Reduction in work hours
Termination of employment
Group Health Benefits Defined
Medical Insurance
Dental Insurance
Vision Insurance
Prescription Drug Programs
Health Flexible Spending Accounts and any self-insured arrangements that provide similar benefits.
COBRA requires employers to offer individuals who lose coverage as a result of a qualifying event the same coverage they had prior to the event. These individuals are called qualified beneficiaries and must be given essentially the same rights as active employees. If the active employees have the ability to change plans or benefits, add or delete dependents during open enrollment periods, qualified beneficiaries have the same rights.
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
COBRA is a law that employers must adhere to by offering continuation of group health benefits to individuals who lose coverage as a result of the following qualifying events.
Qualifying Events
Divorce
Legal Separation
Los of dependent child status
Medicare entitlement
Reduction in work hours
Termination of employment
Group Health Benefits Defined
Medical Insurance
Dental Insurance
Vision Insurance
Prescription Drug Programs
Health Flexible Spending Accounts and any self-insured arrangements that provide similar benefits.
COBRA requires employers to offer individuals who lose coverage as a result of a qualifying event the same coverage they had prior to the event. These individuals are called qualified beneficiaries and must be given essentially the same rights as active employees. If the active employees have the ability to change plans or benefits, add or delete dependents during open enrollment periods, qualified beneficiaries have the same rights.
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
Who am I now and what should I be doing?
So now you have decided that change is a necessary evil. You aren’t happy with your life and it is definitely time to step into the unknown void and take some kind of leap of faith. The problem is that you still don’t have any idea of what to do. If you knew what you wanted, this entire process would have been much easier to begin with and you probably wouldn’t be searching for answers right now.
The good news is that no matter what your age, young or old, you can always change. It’s never too late to add a new dimension to your life. Besides, think of the extra excitement that will come into your life from the changes because there will definitely be a growing process if you embrace change.
So what now? You have made this decision to change and have no clue as to what to change or how to implement changes in your life. Well, for starters, take inventory of yourself and your life. What have you been doing? Did you like any of it? Were there portions that you intensely liked and other portions that were just the opposite? The key is to understanding yourself. Once you start writing down the known quantities, more will come out, more than you think will. Don’t forget to include both business and personal likes and dislikes. There may be something in your personal life that will guide you into a different business. Or maybe there is something in your business life that is directing your personal side. Either way, list all of it and then categorize any information accordingly.
There are plenty of resources to help with your self-discovery. Some options would be to go to a bookstore, library or even do your research on the Internet. Plenty of free information is available in addition to slews of information that can be provided for a fee. Be selective before forking over money to just anyone. There are career counseling services that charge exorbitant fees and do not really provide equal value. Fortunately, there are plenty of free resources.
What have you discovered about yourself? If you do all the above, you will make discoveries. Are you particularly skilled at something? How much do you enjoy doing what you are skilled at? A key point here is that just because you may be skilled at something doesn’t mean that you necessarily enjoy doing it. That is important because understanding what you don’t wish in your life can help you pinpoint what you do want. So if you are hard pressed to determine what it is that you want in a career path, start with what you know you don’t want to do. By eliminating the obvious, you have narrowed the choices and start zooming in on what you do want. Continue to do so until you have a few key areas.
Take those and start researching career paths. At this point, do not be concerned with lack of experience or education. Those will be a part of your process if they are necessary to your change. Right now, research is your goal. Look to see your interests can be related to other careers.
Don’t forget to even examine your own current career that has been making you so unhappy. Is there a way to start including more of the things that interest you and work away from the things that don’t? Have you approached your boss with ideas of projects that you want to do that would benefit both the company and yourself? You may find that the opportunities are right in your path and you have just never seen them before because you were making yourself so unhappy.
You may choose to do something entirely different and that is okay as well. Start researching what you want to do. Take a class, talk to others who do it. Have you been networking? If you aren’t networking, you should be. Networking is a key to having resources to help you on your way. It’s amazing how many complete strangers will extend a helping hand to others just for kindness. It’s a magnificent quality in the human race. Be sure to reciprocate when given the opportunity.
Now that you are becoming more involved in what you want out of your life, you will begin to see even more changes that can be incorporated towards your plan. This has a twofold effect. For one, you are concentrating less on what is making you unhappy which is good. The second is that by focusing on the steps to your goal, your goal will suddenly become the reality before you know it.
"Don't judge each day by the harvest you reap but by the seeds that you plant." Robert Louis Stevenson
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
The good news is that no matter what your age, young or old, you can always change. It’s never too late to add a new dimension to your life. Besides, think of the extra excitement that will come into your life from the changes because there will definitely be a growing process if you embrace change.
So what now? You have made this decision to change and have no clue as to what to change or how to implement changes in your life. Well, for starters, take inventory of yourself and your life. What have you been doing? Did you like any of it? Were there portions that you intensely liked and other portions that were just the opposite? The key is to understanding yourself. Once you start writing down the known quantities, more will come out, more than you think will. Don’t forget to include both business and personal likes and dislikes. There may be something in your personal life that will guide you into a different business. Or maybe there is something in your business life that is directing your personal side. Either way, list all of it and then categorize any information accordingly.
There are plenty of resources to help with your self-discovery. Some options would be to go to a bookstore, library or even do your research on the Internet. Plenty of free information is available in addition to slews of information that can be provided for a fee. Be selective before forking over money to just anyone. There are career counseling services that charge exorbitant fees and do not really provide equal value. Fortunately, there are plenty of free resources.
What have you discovered about yourself? If you do all the above, you will make discoveries. Are you particularly skilled at something? How much do you enjoy doing what you are skilled at? A key point here is that just because you may be skilled at something doesn’t mean that you necessarily enjoy doing it. That is important because understanding what you don’t wish in your life can help you pinpoint what you do want. So if you are hard pressed to determine what it is that you want in a career path, start with what you know you don’t want to do. By eliminating the obvious, you have narrowed the choices and start zooming in on what you do want. Continue to do so until you have a few key areas.
Take those and start researching career paths. At this point, do not be concerned with lack of experience or education. Those will be a part of your process if they are necessary to your change. Right now, research is your goal. Look to see your interests can be related to other careers.
Don’t forget to even examine your own current career that has been making you so unhappy. Is there a way to start including more of the things that interest you and work away from the things that don’t? Have you approached your boss with ideas of projects that you want to do that would benefit both the company and yourself? You may find that the opportunities are right in your path and you have just never seen them before because you were making yourself so unhappy.
You may choose to do something entirely different and that is okay as well. Start researching what you want to do. Take a class, talk to others who do it. Have you been networking? If you aren’t networking, you should be. Networking is a key to having resources to help you on your way. It’s amazing how many complete strangers will extend a helping hand to others just for kindness. It’s a magnificent quality in the human race. Be sure to reciprocate when given the opportunity.
Now that you are becoming more involved in what you want out of your life, you will begin to see even more changes that can be incorporated towards your plan. This has a twofold effect. For one, you are concentrating less on what is making you unhappy which is good. The second is that by focusing on the steps to your goal, your goal will suddenly become the reality before you know it.
"Don't judge each day by the harvest you reap but by the seeds that you plant." Robert Louis Stevenson
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
January 03, 2006
Job vs. Life
Every morning when you wake up there is a part of you that absolutely dreads going to work. Work has become this enormous burden that you carry around with you, dragging you down, holding you back. Yet, you get up and go because you are responsible, there are bills to pay, you need food and housing to survive and working is part of that cycle. Although it is a battle, you find your way to work and every day runs into the next with each day becoming more depressing than the last. There must be more to your life than just this job.
At work, you constantly look for ways out of your situation. You try for different promotions thinking that if only you could get out of that particular job you are in that then things would be better. Unfortunately, you rarely get the opportunity to find this out because you are passed over and other people get the job you try for. Your attitude is showing through and preventing you from climbing higher on the corporate ladder. Now you really are stuck.
The next step is to look outside of work and you start seeking other ways to find a way to make a living without it crushing the life out of you. There must be another way and you are desperate to find it. There are all kinds of advice books and some of them have interesting information but there is one huge problem. You already have a “good” job. If you leave it there will be a huge loss and not in terms of the burden that it has become but in terms of the benefits that it offers. The job is secure, everyone knows you already and it pays benefits. While you certainly could use more money, this job pays “well” and that isn’t something to give up lightly.
So even though the information available offers some enlightenment and may stir you a little bit, the known evil, (current job) remains the lesser of two evils. Staying in a position that you have come to hate and even abhor is still the sensible thing to do. After all, it pays the bills.
The main factor is that despite reading all this information on other career paths, the main thing that strikes you is that you still don’t know what to do. You have never had a plan. Some people appear to have been born knowing what they would do with their life. You just fell into everything and went where the wind carried you. You know there is a better way, obviously having that passion did something for those other people but so far, you haven’t managed to find that elusive factor that stirs your soul deeply enough to leave the known world to explore into the unknown realms. At least not without some sort of security in the works and your existing job is that security.
People fear a lot of things in their lives. Change is one of them and another is success. Success is harder than failure. Indeed, failure comes quite easily. Staying in the job you hate is a form of failure but it is acceptable because you still are being responsible. The bills continue to get paid; you have a roof over your head and food in the house. While it isn’t reaching for the stars, you won’t get burned either.
Success would change your life and in ways that you aren’t even clear on but it definitely would break the routine. Routine is safe and always has been. What would you do with success if you had it? Success is more than just making a lot of money, it has responsibilities all of its own. If success were equivalent with money, all the big lottery winners would be successful, but time and again, it has been proven that these winners often lose everything they have and end up living on Social Security and Food Stamps. You can read about some of them at www.Bankrate.com.
So success isn’t a sudden deluge of money although money is often a part of what we recognize as success. It actually is more than that. Success has to be worked for and planned on. It is important that you actually see yourself in the state that you will be in the future if you do find success. By putting yourself in that state of mind, you will help yourself in more than one way. Seeing yourself already successful will help you to start planning for that success and accommodating your lifestyle to it.
Plan in stages and write down goals, no matter how absurd they may seem to you at the time. As long as you let your imagination be stifled by your current reality, it will be nearly impossible for you to change that reality. As you start to create a mindset that welcomes success, your attitude and behavior will start reflecting what you want to bring into your life.
The important thing is to take action to make it happen but your action doesn’t have to be the leap of faith off of a tall building. Instead, take baby steps and somewhere along the way, you will find the path you have been seeking. Then you can move up to strides. Like all things, it takes time to achieve but it will happen sooner than you think. How do you eat an elephant? One bite at a time. Start chewing.
At work, you constantly look for ways out of your situation. You try for different promotions thinking that if only you could get out of that particular job you are in that then things would be better. Unfortunately, you rarely get the opportunity to find this out because you are passed over and other people get the job you try for. Your attitude is showing through and preventing you from climbing higher on the corporate ladder. Now you really are stuck.
The next step is to look outside of work and you start seeking other ways to find a way to make a living without it crushing the life out of you. There must be another way and you are desperate to find it. There are all kinds of advice books and some of them have interesting information but there is one huge problem. You already have a “good” job. If you leave it there will be a huge loss and not in terms of the burden that it has become but in terms of the benefits that it offers. The job is secure, everyone knows you already and it pays benefits. While you certainly could use more money, this job pays “well” and that isn’t something to give up lightly.
So even though the information available offers some enlightenment and may stir you a little bit, the known evil, (current job) remains the lesser of two evils. Staying in a position that you have come to hate and even abhor is still the sensible thing to do. After all, it pays the bills.
The main factor is that despite reading all this information on other career paths, the main thing that strikes you is that you still don’t know what to do. You have never had a plan. Some people appear to have been born knowing what they would do with their life. You just fell into everything and went where the wind carried you. You know there is a better way, obviously having that passion did something for those other people but so far, you haven’t managed to find that elusive factor that stirs your soul deeply enough to leave the known world to explore into the unknown realms. At least not without some sort of security in the works and your existing job is that security.
People fear a lot of things in their lives. Change is one of them and another is success. Success is harder than failure. Indeed, failure comes quite easily. Staying in the job you hate is a form of failure but it is acceptable because you still are being responsible. The bills continue to get paid; you have a roof over your head and food in the house. While it isn’t reaching for the stars, you won’t get burned either.
Success would change your life and in ways that you aren’t even clear on but it definitely would break the routine. Routine is safe and always has been. What would you do with success if you had it? Success is more than just making a lot of money, it has responsibilities all of its own. If success were equivalent with money, all the big lottery winners would be successful, but time and again, it has been proven that these winners often lose everything they have and end up living on Social Security and Food Stamps. You can read about some of them at www.Bankrate.com.
So success isn’t a sudden deluge of money although money is often a part of what we recognize as success. It actually is more than that. Success has to be worked for and planned on. It is important that you actually see yourself in the state that you will be in the future if you do find success. By putting yourself in that state of mind, you will help yourself in more than one way. Seeing yourself already successful will help you to start planning for that success and accommodating your lifestyle to it.
Plan in stages and write down goals, no matter how absurd they may seem to you at the time. As long as you let your imagination be stifled by your current reality, it will be nearly impossible for you to change that reality. As you start to create a mindset that welcomes success, your attitude and behavior will start reflecting what you want to bring into your life.
The important thing is to take action to make it happen but your action doesn’t have to be the leap of faith off of a tall building. Instead, take baby steps and somewhere along the way, you will find the path you have been seeking. Then you can move up to strides. Like all things, it takes time to achieve but it will happen sooner than you think. How do you eat an elephant? One bite at a time. Start chewing.
January 01, 2006
COBRA vs. Individual Insurance
COBRA is a federal law (Consolidated Omnibus Budget Reconciliation Act of 1985), which allows for the retention of group health insurance for qualified beneficiaries who may have lost insurance through unemployment, divorce, or death. To be a qualified beneficiary, the individual would have either had a termination of their job (for anything other than gross misconduct) or quit voluntarily.
Most employers offer benefits after a probationary period and when an employee changes from one employer to another, there often may be a three to six month window when health insurance would not be available. COBRA was created to help bridge the gap to allow individuals to continue with their existing group health insurance until they could become eligible for new coverage.
The thing that most people complain about is the high cost of COBRA. Why it seems to be so expensive is that most group health insurance provided through employers is also primarily paid for by the employers as a part of the employee's benefits. The premiums paid by the employee are generally just a small portion of the true cost of this insurance. The employer picks up the largest portion of the payments. When the individual is first faced with the true cost of the group health insurance, it seems highly inflated when compared to the partial premiums that had been routinely accepted as the cost for the insurance.
While it is true that COBRA premiums can be high, in recent years, insurance companies are beginning to fill in the gap with individual plans as alternatives to COBRA. However, before signing up for one of those plans, be very careful, because these plans can be a tremendous disadvantage compared to the group health plan coverage that is provided with COBRA.
Individual plans offer insurance tailored to the needs of the individual. For instance, if a person rarely goes to the doctor, the benefits may not cover routine examinations. Instead, the individual plan may cover catastrophic care in which the individual would be hospitalized or for emergency care such as a broken bone. Covering insurance this way helps the individual to keep the overall costs down by concentrating on things other than routine visits.
Caution must be used when giving up COBRA for one of these plans because there are other factors to take into consideration. One area that is problematic is whether there are current pre-existing health conditions. The individual insurance will often reject coverage for these conditions. It may reject such conditions forever or for a limited time, depending on the seriousness of the condition. Pre-existing conditions can include things such as diabetes, high blood pressure, heart ailments or rheumatoid arthritis. These are just a few of the things that may exclude one from individual insurance.
Overall, in these cases, staying with the COBRA coverage is probably the best thing to do because being in the group health insurance has spread the risks over a larger group that kept the costs down and provided extra benefits. This is important because with some pre-existing conditions, there are numerous routine visits per year for maintenance. Often lab work is needed to follow up on the progression of the condition. The prescription drug coverage may be significant as well as all plans are based off of a formulary and changing insurance means that those particular drugs may no longer be covered under the individual plan. Prescription benefits are generally sold separately under individual insurance plans.
Sometimes these pre-existing conditions will preclude ever being accepted by individual insurance plans and it would make sense in these cases to continue with the COBRA coverage until it was no longer available. Another alternative for those individuals faced with the loss of insurance and less than desirable individual insurance is through the state high-risk pool. Check with the state department to find out about this coverage. The high-risk pool coverage may be the necessary way to go to ensure coverage once the COBRA runs out.
The main thing is to do research before letting COBRA go altogether. The good news is that there is a window of time from when first unemployed and when the first COBRA premium is due in which other options can be thoroughly explored. The qualified beneficiary is allowed 60 days in which to elect COBRA and then has another 45 days in which to submit the premiums. One caution about waiting is that COBRA, like most insurance, requires no lapse in coverage so although it may be almost three months before a premium is paid, all back months will have to be paid with the initial premium so now instead of paying one high premium, the individual will have three months worth to pay which can be quite a bit of money at one time.
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
Most employers offer benefits after a probationary period and when an employee changes from one employer to another, there often may be a three to six month window when health insurance would not be available. COBRA was created to help bridge the gap to allow individuals to continue with their existing group health insurance until they could become eligible for new coverage.
The thing that most people complain about is the high cost of COBRA. Why it seems to be so expensive is that most group health insurance provided through employers is also primarily paid for by the employers as a part of the employee's benefits. The premiums paid by the employee are generally just a small portion of the true cost of this insurance. The employer picks up the largest portion of the payments. When the individual is first faced with the true cost of the group health insurance, it seems highly inflated when compared to the partial premiums that had been routinely accepted as the cost for the insurance.
While it is true that COBRA premiums can be high, in recent years, insurance companies are beginning to fill in the gap with individual plans as alternatives to COBRA. However, before signing up for one of those plans, be very careful, because these plans can be a tremendous disadvantage compared to the group health plan coverage that is provided with COBRA.
Individual plans offer insurance tailored to the needs of the individual. For instance, if a person rarely goes to the doctor, the benefits may not cover routine examinations. Instead, the individual plan may cover catastrophic care in which the individual would be hospitalized or for emergency care such as a broken bone. Covering insurance this way helps the individual to keep the overall costs down by concentrating on things other than routine visits.
Caution must be used when giving up COBRA for one of these plans because there are other factors to take into consideration. One area that is problematic is whether there are current pre-existing health conditions. The individual insurance will often reject coverage for these conditions. It may reject such conditions forever or for a limited time, depending on the seriousness of the condition. Pre-existing conditions can include things such as diabetes, high blood pressure, heart ailments or rheumatoid arthritis. These are just a few of the things that may exclude one from individual insurance.
Overall, in these cases, staying with the COBRA coverage is probably the best thing to do because being in the group health insurance has spread the risks over a larger group that kept the costs down and provided extra benefits. This is important because with some pre-existing conditions, there are numerous routine visits per year for maintenance. Often lab work is needed to follow up on the progression of the condition. The prescription drug coverage may be significant as well as all plans are based off of a formulary and changing insurance means that those particular drugs may no longer be covered under the individual plan. Prescription benefits are generally sold separately under individual insurance plans.
Sometimes these pre-existing conditions will preclude ever being accepted by individual insurance plans and it would make sense in these cases to continue with the COBRA coverage until it was no longer available. Another alternative for those individuals faced with the loss of insurance and less than desirable individual insurance is through the state high-risk pool. Check with the state department to find out about this coverage. The high-risk pool coverage may be the necessary way to go to ensure coverage once the COBRA runs out.
The main thing is to do research before letting COBRA go altogether. The good news is that there is a window of time from when first unemployed and when the first COBRA premium is due in which other options can be thoroughly explored. The qualified beneficiary is allowed 60 days in which to elect COBRA and then has another 45 days in which to submit the premiums. One caution about waiting is that COBRA, like most insurance, requires no lapse in coverage so although it may be almost three months before a premium is paid, all back months will have to be paid with the initial premium so now instead of paying one high premium, the individual will have three months worth to pay which can be quite a bit of money at one time.
Jayme@workhorsecommunications.com
www.workhorsecommunications.com
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