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Pearl J | Individual Health Insurance / COBRA? |
Why is COBRA considered better than individual health insurance plans? When I did some research,for almost the same kind of coverage but cheaper premiums, I could find individual health insurance plans.But I keep hearing that given an option, going for COBRA is the wiser decision. I don't understand what the catch could be in these individual plans. Any insight? |
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Curious27
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My experience is the opposite: individual health insurance tends to be a better deal than accepting COBRA. The reason is that employer-sponsored coverage tends to have richer benefits and, consequently, costs more. That's not a problem when the employer is subsidizing the premium, but once you're on COBRA you pay 102% of the premium cost plus any out-of-pocket expenses (deductibles, co-insurance, etc.).
Individual health insurance policies tend to provide core benefits without a lot of expensive frills. So the premium savings can be substantial. You will, however, usually have greater out-of-pocket exposure with an individual plan. So the trade-off you need to consider is balance between fixed costs (premiums) you pay every month and variable costs (deductibles and co-insurance) you incur only if you use the coverage.
There are some other important trade-offs. COBRA lasts only 18 months (under some circumstances 36 months). Although you may qualify for an individual policy now, the risk is you won't when COBRA expires. On the other hand, some states (California is one) have programs for the uninsurable that require you first exhaust your COBRA rights.
A professional insurance agent can help you through this decision based on your unique situation. You can find one from their professional association at http://www.NAHU.org or, in California, from http://www.InsuranceNeighborhood.com .
If you want to check out prices for health insurance there are several online sites available. eHealthinsurance operates in all states; http:/www.InsuranceNeighborhood.com has rates for top plans, but again, only in California.
Hope this helps. |
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kimmy
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i disagree....go with the individual. if you are generally healthy you should be approved for individual coverage. go to the bcbs in your state. their website probably has prices for you. once you leave your employer you have 60 days to elect cobra so in the mean time apply for your own. if rejected then go to the cobra plan. remember the cobra premium is the cost of the insurance company rate for a person on a group health plan plus 2%. you will pay a lot more in premium when you can find a comprable individual health plan. |
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waggy_33
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A lot of long winded answers here.
The COBRA election allows you to continue coverage under your former employers health plan. If you elect this coverage you pay 102% of the premium amount the employer was paying.
If you have a pre-existing condition I would go with the COBRA election.
If there are not pre-existing go with the cheaper coverage. If you go with COBRA and a condition appears in the 18th month your coverage will cease and the individual policy may not be an option.
If you do have some health issues you could elect COBRA, have these things taken care of under the former employers policy and then go with an individual policy. This will keep those costs out of the claims record for the individual policy.
Good Luck! |
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mkulda
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There's one thing being left out that is very important to consider.
It's another acronymn called ERISA.
COBRA, which stands for Consolidated Omnibus Budget Reconciliation Act (from the Reagan days), is a plan that allows you to continue your employer's coverage for up to 18 months, as long as you agree to pay 100% of the premiums.
For most people....that's going to be a problem. They don't realize it, but most employers pay 60, 75 or even 90% of the full premium and the employee pays only $150-$200 a month, but thinks that's the whole premium when its not.
A typical family premium under COBRA is close to $1200 per month or more....which most people just can't afford.
Here's where the ERISA problem comes in.
If you work for an employer with more than 50 employees, the health plan is something known as an ERISA plan. ERISA stands for Employee Retirement Income Security Act...another big federal bill that allows big employers to 'self-insure' the health care of their employees...but and this is the key....they are allowed to 'opt out' of any coverage mandates they want.
What this means is that typically....an ERISA plan's coverage is not nearly as complete as what you'd be able to buy in an individual plan, because you employer has been allowed NOT to have to pay for a whole host of ailments that are excluded under ERISA but required to be covered under individual plans. (if you read carefully your employers booklet and see what is NOT covered...you'll be shocked). The ONLY health benefit mandates required under ERISA are reconstructive breast surgery after mastectomy and maternity (if the employer has more than 15 employees)....ANY other health benefit is able to be excluded by the employer if they want....and many do.
So....stay with me here...you could COBRA (or continue) your current ERISA plan (from your employer's coverage plan) without having to worry about pre-existing conditions....but the costs would be very high (since you are paying the full bill) and the coverage benefits are scaled back.
You are likely better off going to the individual market, if you can tinker enough with co-pays and deductibles to get a decent rate.
The benefit of staying with an employer's plan is that you get continuity of care and the ability to get a rate quote that has you in a group (insurers give discounts for groups....individuals don't get those).
But the benefit of an individual plan is better coverage for more ailments and more ability to adjust as necessary the policy terms. |
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Jen
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the laws are kind of strange, but basically, if you get an individual policy, you do not have the same protections from pre-existing conditions. lets say you have a policy from work, and you have diabetes as an example. the individual policy is not required to cover your diabetes. that's pre-existing. lets say you have a individual policy, and you develop diabetes. well, when you go back to work, the work policy can exclude you, usually up to 12 months, from covering expenses related to that. if you mess up on the individual policy application, and leave any information off, or give incorrect info, they can also go back and deny they claims too, saying that it was, or should even been suspected, that what you had, was pre-existing.
so basically, your just taking a big gamble if you get an individual policy. |
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united9198
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COBRA is an extension of your existing health insurance at work. That usually means that you are protected from the issue of getting canceled for pre-existing conditions.
Private insurance does have a problem with that issue. Usually you are required to fill out an elaborate application and any incorrect statements or omissions of fact could result in the insurance company RETROACTIVELY canceling your coverage. In other words, you could need or have expensive health care and end up with the insurance company denying the claims.
I would go with the COBRA while you look for another job with insurance coverage. Of course if you are very healthy and plan to have new coverage quickly, you might want to take a chance on private insurance if the price is considerably lower. |
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yocum
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I think individual is better. You do have to fill out an application but if you don't get a job with health insurance you are going to fill out an application anyway. Oh ya individual is a lot cheaper.If you keep cobra you will be paying the price your employer is paying who is paying to insure the
un-insurable person not like individual. |
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Amy
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COBRA is generally a better choice because it is an extention of your previous plan, therefore any pre-existing condition does not have a waiting period. Also, by federal law, you have to be allowed to carry that coverage at the same group rate with no more than a 2% administrative fee added. Considering that, it could be cheaper to choose the COBRA. Be sure and check co-pays, deductibles, and out-of-network charges when shopping for new coverage. Also think about your medical history and what service you use most frequently. I hope this helps. |
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