Insurance Concerns: Know Your Benefits

If you are considering a reduced work schedule or a different job, it's important for you to check on how that change would affect your existing benefits. Most jobs require full-time work status to be eligible for health insurance benefits and long-term or short-term disability benefits. If you were to change to part-time work status, it's possible that your benefits would be either lost or reduced. Once again, you want no surprises — be informed.

Alert

It's hard to think about future disability while still wanting to work for as long as possible. Being realistic will help you down the road. If you have a disabling type of arthritis that may lead to living on disability payments, plan ahead for that inevitable day.

Knowing Your Benefits

To know how a change in work would affect your benefits, you need to know the details of what your benefits are now. Too many people don't take the time to investigate the details of their current benefits. Don't wait until you have to see a doctor or be hospitalized or need a prescription drug to know your share of the responsibility and what is paid by your health insurance plan. Learn about it before you need it. Also, don't wait to find out what would cause you to lose those benefits; learn about it before it becomes an issue.

Employers Can Change Health Plans

If you change jobs, your health plan may also change. Even as a long-term employee, your employer may change health plans, and it's important to find out how the change will impact you and your family. Is your doctor still on the list of providers with the new health plan? Have the deductibles and coverage changed? What provisions are there for a person like you who has a pre-existing condition? Try to avoid a lapse in coverage when changing insurance to decrease the likelihood of limiting coverage for pre-existing conditions.

Because you do have a chronic medical condition, all of these factors are much more critical to know than they are for the average healthy person.

HIPAA May Offer Protection

HIPAA, the Health Insurance Portability and Accountability Act of 1996, is a law designed in part to help you avoid the loss of benefits if you move from one group plan to another group plan. HIPAA states that group health plans cannot deny you based on your health status. HIPAA limits exclusion to health insurance based on pre-existing conditions if you change jobs or if you lose your job. In the event that you change or lose your job, HIPAA guarantees the availability and renew-ability of health coverage for some employees and individuals.

HIPAA also forbids the denial of coverage because of mental illness, genetic information, disability, or prior claims. HIPAA rules apply to all employer group health plans that have a minimum of two participants, and in some states, groups of one.

HIPAA's rules about insurance portability do not guarantee the same benefits, premiums, deductibles, or copays when moving from one group health plan to another. There are also rules that allow your current health coverage to be creditable within your new health plan: The time you were enrolled in the old plan is credited against an exclusionary period.

COBRA May Help

Many employees are unaware of COBRA benefits. According to the U.S. Department of Labor, COBRA, an acronym for Consolidated Omnibus Budget Reconciliation Act, “…provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, though, than individual health coverage.” You can find more important information about what qualifies a person for COBRA online (www.dol.gov/ebsa/faqs/faq_consumer_cobra.html).

  1. Home
  2. Arthritis
  3. The Financial Impact of Having Arthritis
  4. Insurance Concerns: Know Your Benefits
Visit other About.com sites: