Monthly Archives

May 2014

Spending too much for Health Insurance on COBRA? Now’s your chance to move directly into a more affordable ACA plan!

By Obamacare, Understanding Health Care Reform No Comments

The Department of Health and Human Services announced a 60-day special enrollment period (SEP) for anyone who has COBRA group health benefits continuation coverage. With this announcement, COBRA enrollees have until July1, 2014, to change to an Affordable Care Act (ACA)-compliant plan. To take advantage of this SEP, COBRA enrollees have until July 1, 2014, to apply for an on-exchange plan or for an Anthem plan. Under COBRA (the Consolidated Omnibus Budget Reconciliation Act), people who lose their jobs may buy the coverage they previously had through their employer, but they have to pay the full cost for each month during the 18-month continuation period. Previously, once you opted for COBRA coverage the only time to change your plan from COBRA to an ACA compliant plan was during the Open Enrollment Period (October 15-December 7) or at the end of the 18-month continuation. However, with the HHS announcement, individuals who…

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How Hospital Outpatient status can cause trouble for you!

By Making the Most of your Medicare, Understanding Health Care Reform No Comments

Knowing the distinction between observation care and inpatient care (admitted patient) is important for seniors. If you have not been admitted to the hospital for at least three consecutive days (two midnights) you are not eligible for follow-up nursing home coverage and may have higher out-of-pocket expenses while in the hospital. Furthermore, drugs that you receive during observation care are not covered – you are charged full retail value of drug. Under the rules, Medicare picks up the whole tab for the first 20 days in an approved skilled nursing facility for rehab or other care, but only if someone has spent at least three full days (two midnights) in the hospital as an admitted patient. If instead a patient has been under observation — for all or part of that time — he or she is responsible for the entire cost of rehab. FAQ: How does this affect me…

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By Making the Most of your Medicare, Understanding Health Care Reform, Wellness Wednesday No Comments

Tuesday afternoon I sat in my office with a cup of piping hot coffee and reviewed the onslaught of mailers and solicitations that had been piled on my desk. About halfway through my coffee I uncovered a solo postcard; a reminder that I am due for my annual “Well-Woman” exam, a once-a-year visit to a woman’s primary care provider for a general health check. Not only did my doctor’s simple encouragement motivate me to make an appointment, it also stirred my curiosity. Why did we go from a society that only visits the doctor when sick to one that visits regardless of our state of health. Furthermore, how does this affect my client, the Medicare beneficiary? Why did we go from a society that only visits the doctor when sick to one that visits regardless of our state of health. The most recent push for preventive medicine, i.e., annual check-ups, came with…

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By Obamacare No Comments

  DON’T FRET! Open Enrollment is closed until October 2015 but you may still qualify for coverage.  Open Enrollment for 2014 coverage is over. But you may still have options to get health coverage. See if you qualify for a Special Enrollment Period – so you can buy a private health plan through the marketplace. To qualify for a Special Enrollment Period you must experience a qualifying life event:           -Recent marriage, divorce, new baby or adoption?           -Moved out of state,  gained citizenship, left incarceration?          – Lost other health coverage due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a                       parent’s plan, losing Medicaid or CHIP, and similar circumstance.          -Did you have…

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