December 22, 2009
How to Choose Between an HMO and PPO Health Plan When Your COBRA Health Insurance Coverage Expires
Due to the challenge associated with obtaining health care during bouts of unemployment, the federal government decided in 1986 that there was a need to provide protection to these unemployed people. As a result, COBRA (or the Consolidated Omnibus Budget Reconciliation Act) was passed. As long as the unemployment was not due to 'gross misconduct', this law allows people who voluntarily resign, are laid off or terminated the right to extend their health insurance coverage for up to a year and a half at their expense.
You can qualify for COBRA health insurance coverage in cases where the employer you no longer work for had a group plan with a minimum of 20 employees enrolled into it and you were a member of that plan for at least six months. If any other members of your family were also enrolled under the same plan, they are also able to get COBRA- even in the case that you choose to not get it yourself. The nature of your 'qualifying event' can mean that you can get COBRA benefits for up to 36 months.
There is a steep price that comes with COBRA continuation of coverage benefits; with administrative fees this cost amounts to 102% of the actual cost of the insurance. This can cost you practically your entire unemployment amount, but you can possibly recoup some of this cost if you qualify for reimbursement of premium cost under the American Recovery and Reinvestment Act of 2009. This provision will enable to you to get up to 65% of the total cost back for a total period not lasting more than 9 months.
Before your COBRA continuation of coverage benefits expire, you should take a look into the purchase of an individual policy for yourself or any other person who was covered under your COBRA benefit. Private policies come in the form of HMO and PPO plans. Though you may not be familiar with these plans, these are common health health insurance terms for managed care systems. If you are a member of an HMO (Health Maintenance Organization), you have one specific physician who acts as the gateway to all other heath care services you may need. In opposition, being a member of a PPO (Preferred Provider Organization) means that you can acquire care from any doctor in your network.
The decision between HMO vs PPO insurance is an easy one to make when you keep certain things in mind. Cost is not a good determining factor because it is similar in both plans. The PPO plan is a good choice for those who value freedom in choice; you can go to any doctor or specialist you want for your care as long as they are in the network. with a HMO plan, you have one specific doctor who acts as the gateway to all of your medical care, so when you have a particular individual you trust for all your concerns, this may be good for you.
Learn more about PPO vs HMO insurance. Stop by Kristaria Dawson's site where you can find out all about HMO and PPO health plan options.
Filed under Health Insurance by Sharon Matthews
