If you have health insurance through your work and you lose your job, it doesn’t mean that you have to lose your medical coverage as well. There’s a variety of ways to stay with Kaiser Permanente. The most common ways are: an Individual and Family Plan, COBRA, or a Conversion Plan, also known as HIPAA. Below are some comparisons to help you determine what’s best for you and your family.
Of the three options, these plans are oftentimes the lowest-priced option. There is an exception. If you worked for a large company (50 or more employees), then sometimes, a COBRA plan could be lower priced. Unlike group insurance, which usually offers a single one-size-fits all plan, Individual and Family Plans allow you to match the benefits and price to your needs. Individual and Family Plans are ideal for persons who have no, or minor, medical conditions. Eligibility is subject to medical underwriting, so enrollment is not guaranteed. If approved, however, you can stay on the Individual and Family Plan indefinitely; it’s not tied to your employment. Coverage is month-to-month, so if you wish you can cancel the insurance when your new employer’s plan kicks in. Individual and Family Plans are often the best option for people who are in-between jobs.
If you need a plan that does not require medical underwriting, then you might consider COBRA. COBRA allows you to temporarily keep the same benefits that you had on your group insurance. The premium will be the amount you paid plus the amount subsidized by the employer. If you work for a large company, there is also an administration fee. New legislation may make COBRA a more affordable option than before. For information about the COBRA premium subsidy program, visit the Department of Labor’s website. If the company has gone out of business, COBRA is not an available option.
If you need a plan that does not require medical underwriting or the company has been dissolved, the Conversion or HIPAA (Health Insurance Portability and Accountability Act of 1998) Plan may be your only viable option. Conversion allows you to convert your existing group insurance into an individual plan. The benefits will not be the same as what you had under your group insurance and the cost will probably be more expensive, approximately 170% of Kaiser Permanente Individuals and Families Plan rates. The advantage of a Conversion Plan is that you won’t be denied for pre-existing conditions. To qualify, you must meet all of the following five requirements:
1. You must have at least 18 months of creditable coverage without a break in coverage of more than 63 days at any time.
2. Your most recent health care coverage must have been through a group health plan, governmental plan, or church plan.
3. You must have elected and exhausted all continuation health care coverage available under federal (COBRA) and state continuation coverage laws.
4. You must not currently have other health care coverage and not be eligible for coverage under any group health plan, governmental plan, church plan, state-administered Medicaid program, or Medicare.
5. Your most recent coverage was not terminated for fraud or failure to pay premiums.
For more information about the Conversion or HIPAA Plan, call Kaiser Member Services at 1-800-634-4579.
If you do lose your job, your employer may or may not be able to help redirect you to an alternative option. Knowing that options are available can make the transition a little bit smoother.
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