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Medical Insurance Payment Assistance & Options

 

Information gleaned from various sources.

Contact the references for up to date information.

Your Comments on This Section Are Welcome

General:

     Nearly everyone begins on a COBRA plan. Your plan may be more expensive than other options. We've listed a few of these below. It is likely you can save a hundred dollars or more by changing to a non-COBRA plan.

     But the first order of business is to apply for Mass. Benefit assistance.  This can be worth a bit over $500 per month in non-taxable support. The income limits are not that stringent particularly if you've been out for. See next section. We don't know if Gov. Romney's cuts will affect this.

1. Payment Assistance Benefits

a. Massachusetts Medical Assistance Plan:

Massachusetts offers payments of up to $532 per month to people currently receiving unemployment benefits and whose family income, including unemployment benefits, that is lower than plans' income limits. [Example: family of 4 = $73,600]. You must pay 100% of your premium and have an invoice to supply to the plan administrator. There are other qualification criteria and benefits above the $532 reimbursement. Managed by BCBS. Found they were very helpful.   

Note: You should apply even if you exceed the income guidelines because after a few months you may not and the plan will kick-in. BCBS should contact you at that time - (I was told this, but you should confirm this when you make your initial call.)

See http://www.detma.org/workers/msp.htm#Premium or call 800-914-4455

Also see: http://www.detma.org/workers/msp.htm for details (just a few pages)

The state also offers a Direct Coverage Plan, but you have to be in real financial difficulty. Same contact info as above.

b. MassHealth Buy-In:

This program is for those who have run out of unemployment benefits and can't use the benefits of the Medical Security Program (above). To qualify, your spouse cannot work more than 100 hours per month.

Enrollment Center 1-888-665-9997; Customer Service Center 1-800-841-2900

c. Insurance Partnership:

Can pay half of health insurance premium for families if either husband or wife is "self employed". NOTE: Contact them even if you're not as you may still qualify with a business certificate from your town hall.

http://www.InsurancePartnership.org 800-399-8285

2. COBRA

If your previous employer provided health care coverage they will offer to have you continue coverage under the same plan. You will likely be required to pay the full premium. Since most people laid-off are given very little notice, you should elect this option - at least for the first month.

You should immediately look at other options because the savings for comparable plans can be significant. Generally you can sign up for another plan at any time, but usually the first of a month.

3.      Medical insurance and COBRA

A.    If your COBRA benefits expire, the insurance company may be willing to roll you into a non-group plan. In evaluating your options, you should check this one out. Also see the next section for contact information.

     Per a FENG (Finance Exec. Networking Group) member; "Whatever you do, don't let medical coverage lapse for over 60 days."  i.e. after your COBRA runs out. You must get new insurance prior to the 60 days. Insurers in MA will require a HIPPA (health insurance portability.) certificate as proof of when your last coverage ran out. If it is over 60 days you may be ineligible for some plans offered by the state except during open enrollment once per year October"

      Information on COBRA: http://www.dol.gov/dol/pwba

4. "Health" Insurance Options

Direct to the Insurance Company

Many times the rate can be less than COBRA, but they are unlikely to compete with offerings associated with groups (see below)

Contact information: Ask for the "Non-group" sales department

a. For a comprehensive list of companies and sample rates see http://www.state.ma.us/doi/Consumer/css_health_plans01-12_2002.html . You must have Adobe Acrobat Reader to read the linked filed. If you don't have it get a free copy at http://www.adobe.com/products/acrobat/readstep2.html

bBCBS Ask for "Health plans for Individuals" 800-422-3545. http://www.bcbsma.com 
Ask for HMO & PPO Blue Direct 
Also See Top three paragraphs http://www.bcbsma.com/common/en_US/healthPlansIndex.jsp?levelTwoCategory=Other+Plans&targetTemplate=titleBody.jsp

c.  Harvard Pilgrim Health Care - 800-208-1221 HPHC Non-Group Sales Department. www.harvardpilgrim.org 

Also see this link for benefit options. Costs are not shown. http://www.harvardpilgrim.org/public/coverage/cc%201679.pdf

d.  Tufts  http://www.tufts-health.com Rules: important: Must elect to enroll within 30 days of termination. Call Customer Relations Coordinator at 800-462-0224 and hit option 2.

See the following link bottom of the page. http://www.tuftshealthplan.com/providers/provider.php?type=prov&sec=news&content=grpcov-cobra&rightnav=grpcoverage

Self-Employed People:

Note: There are many alternatives for people or their spouses that are/were self-employed. The term "self-employed" is not what you may think - so don't rule yourself out. The qualification criterion varies for new businesses and for existing businesses.  If your spouse is self-employed but you got your coverage from your employer you can automatically qualify through your spouse.  If your spouse is employed, but you used your job for health insurance coverage - switch to your spouses employer.

Otherwise, you have to get creative and find the best way is to become "self-employed" as defined by the provider. Most of the references listed below "want" your business. Talk to them. Ask about their qualification criteria and attempt to meet it. In some cases it's as simple as having a Business Certificate [available from your Town ($20)] and a letter on your letterhead. So don't rule yourself out.

a.      HSA (Health Service Administrators): [Part of Mass Business Association].  $100 one time fee to join.  Offers a variety of plans including Tufts and HPHC. Competitive rates.

b.      Qualifications appear to be flexible but they are targeted to existing self-employed people you or your spouse. Divided into "new" businesses and existing businesses. Existing businesses - "remember your spouses business qualifies" only needs a Federal Income Tax Schedule C or K.

c.      New business: Need proof: Business Certificate from your town hall ($20) and/or invoice and/or a letter on your letterhead indicating you're the only full time employee.

d.      Call Jodi Sargent or Holly Tarrant at 781-228-2171; They are very helpful

e.      SBS: Worcester - same kind of organization as AIM. Call 800-222-5678

f.        National Association For the Self Employed - Provided by Mega Life & Health Ins. Contact Jim Connington, Tel. (781) 982-2290 ext: 282 or e-mail at JimConnington@aol.com or see their web site at www.naseweb.com/JimConnington.htm

Other Options

a.       Veterans: For the veteran alone - no family coverage. You need a DD214 form. [Per Larry Colvin, DET] Go the nearest outplacement clinic - Worcester 508-856-0104, Framingham: 508-628-0205

b.      MassHealth for the Long-Term Unemployed: Must meet very low-income cut-off. Contact 800-841-2900

c.      Other organizations: Organizations like the IEEE may offer insurance options.

  General Information

i.      Contact MA Division of Insurance Consumer Section at 617-521-7777 and explain your situation for a list of insurers and rate comparisons. You can also go on the their web site and dig it out. http://www.state.ma.us/doi/Consumer/CSS_health.html

ii.      Mass Small Business Association: http://www.mbainsurance.com 

5.    "Dental" Insurance Options

Difficult to get. Let us know if you know of any other options

a.     National Association For the Self-employed It is Mega Life & Health. See above for contact info.

b.     Also try http://ameriplanusa.com/  We have not investigated this, but a member offered this option that provides dental coverage for people when they join a network