Kicked Off your Parent’s Health Plan? Check Out These Options

February 14, 2013

Are you a young adult who is covered under your parent’s health insurance plan? If you’re among the millions who are, you’ll need to find new coverage when you turn 26, according to a recent story in MSN Money in which Health Advocate was used as an expert source. To view the full story, click here.

The Patient Protection and Affordable Care Act allows a dependent to stay on a parent’s health plan up to age 26. Whether the coverage ends on your birthday, or at the end of the policy year, depends on the plan. If you are now 26 or approaching your 26th birthday, you will need to look into other health insurance options. It’s important to plan ahead instead of waiting until the last minute.

Health Advocate provides the following tips:  

  • Enroll in your employer’s plan. If you have a job that offers health insurance, talk to your benefits administrator and learn how to enroll. Typically, you would have to wait until the open enrollment period to sign up for health insurance, but under federal law you can sign up outside of the open enrollment period if you’ve lost coverage on a parent’s plan.
  • Spouse coverage. If you have a spouse or domestic partner who has employer-based health insurance, see if you qualify for coverage on his or her plan.
  • Think about COBRA. The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a type of insurance for people who lose employer-sponsored health insurance because of unemployment, divorce, death of a spouse, or loss of eligibility for coverage as a dependent. Under COBRA, you can continue to receive health insurance benefits under your parent’s plan for up to 36 months.
  • Shop around. Look for an individual policy. You might find affordable coverage if you work with an independent insurance broker or agent. Figure out the type of healthcare you will need. If you are relatively healthy, you might not need a plan with all the bells and whistles. Keep in mind that the higher the deductible means a lower premium, but more out-of-pocket costs.  
  • Check out Medicaid.  If you are a low-income individual or family, look into federal and state programs.

To learn more about how to find affordable healthcare coverage, check out The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed and Anyone Else Who Wants to Save Money. The book, written by Health Advocate cofounders Martin Rosen and Abbie Leibowitz, M.D., contains dozens of resources to help find affordable healthcare coverage and health services for anyone who has lost their employer-paid healthcare — or who simply wants to reduce healthcare costs. You can download the book for free at www.HealthcareSurvivalGuide.com.

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PHA Case Study – Unreasonable balance for a surgery bill

June 24, 2011

Situation 

Sharon had emergency surgery at an in-network facility, but was left with a large out-of-network balance on her bill because the on-call surgeon who performed the procedure was not in her plan’s network. Although the claim was already paid by her insurance company at the highest plan benefit level (90 percent of allowable). Sharon was still left with a $4,230 balance. Her Personal Health Advocate negotiated with the doctor to lower her payment to $2,000 and saved Sharon $2,230.

What The Healthcare Survival Guide Says

Step up and negotiate with your doctor or hospital to get a discount on your claims – 61 percent of patients who asked for a discount form their doctors got one (pg. 36). In some cases, hospitals offer a significant dollar or percentage discount if you pay cash (pg. 43). Keep track of the hospital care you receive; make a list of all your procedures, tests, medications and supplies. This will help you when you need to review your bills later. Double-check and question every charge. Overcharges such as being charged for the wrong number of days in the hospital are common (pg. 43).

For more in-depth advice on this topic, check out our blog post on negotiating with your doctor.

If you would like a free copy of The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed and Anyone Else Who Wants to Save Money, you can download it at www.healthcaresurvivalguide.com.


PHA Case Study – Contending with Billing Errors During Recovery

June 17, 2011

Situation:

Patricia experienced a “bombardment” of incorrect bills related to the testing and hospital stays she underwent resulting from a brain tumor. Her Personal Health Advocate addressed the billing errors and also helped her find facilities for further testing and treatment covered by her health insurance plan. When she had a subsequent seizure and fractured her forehead in a fall, she was again bombarded with incorrect billing errors. The same Personal Health Advocate was able to help Patricia resubmit the appropriate paperwork and to have the bills corrected for payment. After the situation was settled, Patricia said, “On top of my brain tumor, I was faced with a bombardment of billing errors. They handled the paperwork with compassion and persistence. Thank you, thank you!”

What The Healthcare Survival Guide Says:

Keep a close watch on your medical bills. Compare them against the Explanation of Benefits statement received from your insurance company (pg. 41). To avoid other errors involving your care—such as mix-ups in diagnoses and medications – put together your own personal health record to record your medical history, past procedures, diagnoses, medications, allergies, etc. (pg. 53). It’s just one way, along with free or low-cost prevention measures like regular screenings (pgs. 54-55), to take charge of your health and reduce doctor visits and medications.

If you would like a free copy of The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed and Anyone Else Who Wants to Save Money, you can download it at www.healthcaresurvivalguide.com.