Know the Facts About Cobra Insurance Extension
Are you one of the many Americans who have been laid off in recent months? Are you concerned about no longer having health insurance benefits for you and your family in addition to the loss of income? If so, you will want to know more about the COBRA Insurance plan provided by the federal government.
Don’t make the mistake of thinking that you don’t need health insurance. If your health insurance lapses, you may have a problem covering yourself and your family when you do get a new job. It is also not a good idea to ‘play the odds’ and hope that you will not need medical coverage; it is impossible to predict when accidents or illness may occur.
Qualifying for COBRA
The COBRA benefit provides a supplemental insurance policy that bridges the gap in coverage between employment. The individual’s most recent employer is the provider of the plan. You can receive this benefit if you have been terminated for any reason other than gross misconduct, laid off, or have had your hours reduced to part-time status which disqualified you from receiving health insurance. The coverage also applies to your family members who were previously included in the policy.
The American Recovery and Reinvestment Act (ARRA) includes a Cobra Extension that extends benefits to those former employees who were laid off or terminated between September 2008 and February 2009. If you still do not have health insurance due to an employment separation that occurred between that period of time, you can now elect to receive COBRA benefits.
The Cost of COBRA Insurance Extension
Be aware that after separation from your employer, you will have to pay the entire health insurance premium out of your own pocket. However, there is some good news. For one, the cost is often less expensive than acquiring an individual insurance plan. The second piece of good news is that the federal government offers a subsidy to those who cannot afford the premium, up to 65%.
What to Do When You Lose Your Job
The responsibility of reporting a layoff or termination is up to the employer. They have 14 days to do so. Eligibility for COBRA insurance extension is determined by a number of factors including the size of the employer, the circumstances of separation, and many other rules and regulations. It may be helpful to use the services of a consultation company to help you sort through the details.
You should also be aware that there are time limits in place. There is a 60-day period in which the separated employee can decide whether or not to receive continued health insurance coverage. After that, you will have 45 days to pay the initial premium.
In addition to federal regulations, each health insurance provider will have its own rules and requirements regarding how claims are filed. They also have the option of ruling you ineligible for plan benefits. If you are denied COBRA benefits, you have the option of protesting this assessment within 60 days. Of course dealing with an insurance company is never uncomplicated so this may be another instance when assistance is required
There are many rules, regulations, and stipulations that apply to COBRA insurance extension benefits but there are also resources available to make the process easier. Look into the options today and don’t be left without health insurance.
Learn more about Cobra Extension. Stop by our site where you can find out all about Cobra Insurance Plan and what it can do for you.
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Read More...Do Insurance Companies Cover Lap Band Surgery?
When you plan to have lap band surgery, one important factor you have to consider is how you are going to pay for the weight loss surgery. Insurance coverage for Lap Band surgery is normally granted or denied on an individual basis. For this reason, you have to be aware of your particular insurance providers policies.
When reviewing your insurance policy, you should look at the area in your policy that states: “What Is Covered” or “Covered Expenses.” These are the healthcare benefits that the insurance provider will cover. In this section, search for a statement that says the provider excludes coverage for “weight control, for the treatment of obesity, for the surgery for weight control, or for the complications of the surgery for weight control.” Some providers will state they exclude all forms of weight loss surgery while others will state certain areas that they will provide coverage. For instance, they may state they will cover “when deemed medically necessary.” The policy will likely state certain conditions that must be met. You need to find out about their exact conditions.
You should also check to see if you can get partial coverage. There may be a way to have some areas associated with the lap band process covered such as hospital fees.
The following is a list of insurance providers that either partially or completely cover Lap Band surgery:
Blue Cross (some states) United Healthcare Oxford Health Plan Medicaid American Family Insurance Humana First Health One Health Tufts Health Plan
One will require a Letter of Medical Necessity and a history of your weight loss attempts in order to be granted coverage for the surgery. The following information is usually included in the Letter of Medical Necessity:
A weight that should be 100 pounds or more above your ideal weight. List of medical problems associated with obesity, such as type 2 diabetes, sleep apnea, hypertension, etc. Number of years that you have been overweight (at least five or more) A detailed list of all your weight-loss attempts
Source: lapband.obeseinfo.com.
Most insurance companies will rely on the National Institute of Health (NIH) guidelines to determine if a client should have weight loss surgery coverage. The NIH guidelines state that weight loss surgery may be an option for patients who “1) have failed with other weight loss treatments and 2) have a BMI of 40 or greater, or have a BMI of at least 35 and co-morbidities.”
If your insurance plan has an exclusion listed for weight loss surgery, you may still be able to get approval. You will have to appeal the exclusion and get a letter from your physician stating that lap band surgery is the best method of treatment for your life-threatening condition. Such health conditions can include: diabetes, high blood pressure, and heart disease. You may possibly get approval for weight loss surgery as a treatment for one of these health conditions.
Lap band surgery is an expensive weight loss procedure. If obesity is a serious health risk, it is important to check with your insurance provider to see if you are covered.
Weight loss surgery clinic offers the safest sustainable results in weight loss by reducing the amount of food your stomach can hold. Visit the lap band surgery Toronto to lose weight without hunger and feel full longer with the Lap Band.
