Health Insurance Navigator

By Lisa Zamosky

From time-to-time, readers of this blog ask for feedback about their particular health care or insurance situation. Here’s one question recently submitted:

I have health insurance through COBRA, which costs me over $500 a month. My medical bills consume over half of my long-term disability benefits every month. My COBRA eligibility is ending soon and then I’ll be uninsured but not eligible for Medicaid. What now?

Medicare Coverage

You mention that you’re receiving long-term disability benefits. If you have a medical disability and have been receiving Social Security Disability Insurance (SSDI) for more than 24 months, you may be eligible for Medicare coverage.

Eligibility for Medicare kicks in during the month you receive your 25th SSDI check. You should be contacted automatically by Social Security and receive a Medicare card in the mail three months before you become eligible.

To talk with someone about your particular situation, you might try contacting your local Social Security regional office.

Know Your COBRA Rights

It’s important that you understand your rights under COBRA, particularly if it turns out that Medicare is not an option for you.

In addition to your right under federal law to continue your group health insurance for 18 months after leaving or losing a job, once you’ve exhausted your 18 months of COBRA benefits (in some cases COBRA can be extended for longer periods), federal law guarantees you an insurance plan on the private market.

Every state is required to offer at least one “guaranteed issue plan” (sometimes called HIPAA plans). In some states you can buy a plan from any insurer that sells policies to individuals. In others, particular health plans are designated.

Get in touch with your state’s department of insurance to learn how things operate where you live. Contact information can be found at the National Association of Insurance Commissioner’s website.

And be sure to get a certificate of “credible coverage” from your previous insurer, which is a document that proves to a new company that you had prior coverage. Without it, you can be turned down for a new plan.

Find Coverage You Can Afford

You say that you’re not eligible for Medicaid, and you may be right about that. Still, I would urge you to double check, as well as to make sure there are no other public programs offered in your state for which you’re eligible. You can do that by taking a quick, five-question eligibility quiz created by the Foundation for Health Coverage Education at www.CoverageForAll.org.

Also, it’s a good idea to work with an experienced insurance broker in your area. These folks can be enormously helpful to you in searching for a less expensive health plan that meets your needs.

You can find a licensed insurance agent in any state at the National Association of Health Underwriters website.