Health Insurance HELP!!!!!!

[chick06]

Ok, I am so upset I hope I can type. My daughter that is the NICU nurse and has worked for the same hospital for 10 years just got an email that all nurses working 32 hours will not have insurance come July 1. That means my grandson that takes chemo will not have insurance. She had went to 32 hours in the summer to be home more with him. You had full benefits if you worked 32 hours. Today for some reason things changed, nurses that have worked 4 8hour shifts for 20 years, come July do not have health insurance for their family. She called crying, and of course she makes to much to get any help from other sources. Who will take my grandson with his disease, 2011 does not seem to be starting out very good. Any advice would help. Just had to vent, health care reform where are you????

[lawinkle]

Until I have the opportunity to think more deeply about your question, my first thought is to ensure that your daughter keeps some kind of coverage in insurance so there is no lapse.....

I would be concerned that if there was a lapse that she might not be able to get affordable coverage even though they tell us that they can no longer exclude us if we have a preexisting condition like your grandson's.  Not excluding us is one thing...being able to afford it is another....can she get COBRA coverage while she considers her options?

I was afraid that employers would drop employees under this new reform and just pay the penalty...cheaper than paying for coverage...

[Kay/NC]

Do NOT panic yet... simplest question is whether or not she can go back to 40 hours to pick  up coverage under the new rules. Not a perfect solution, but perhaps a necessary one. 

Sometimes, that can mean four  tens a week, instead of four eights.  I know of hospitals where working two twelves on the weekend equates to a forty-hour pay week.  Perhaps the administration has plans ot help employees work their benefits eligibility in with differential scheduling. 

Next, get her to check into SCHIP for him and his sister.  Every state is required to have a children's health insurance program.   There may be a needs-based level of income that excludes them from this coverage, but it is somehwere to start checking. 

Also, check into whether or not she can carry COBRA coverage...the federal government has capped the premiums, but I cannot remember for how long.  Don't know if this applies to cutbacks in coverage to fulltime employees only, but it does apply to people who become unemployed. 

What about buying into coverage at his Dad's workplace?  I'd go take a job at Home Depot for eight bucks an hour to quailfy for coverage, if my child needed to have a policy over his head. 

Let me know what you find out.  I will try to ask a few more questions...I have a friend who manages a unit at the hospital, and he may be able to suggest some ideas, too.  Oh, and one of my classmates used to serve as "vanguard" at the hospital, where she helped people find a way to pay for care.  I'll try to ask for her guidance, too. 

[chick06]

I am not sure about the Cobra, but she is going to contact Blue Cross tomorrow, they also carry her insurance now. SHe is just going to buy an additional family plan if she can. Her husband is self-employed, so she is the insurance provider. There are not any additional hours, I just hope before July there may be. She has always worked in the NICU but she will transfer anywhere she can get the hours, but with his treatments it will have to be a night shift, and right now they do not need the help. Please let me know anything anyone can find out.

[k2reinhardt]

She will qualify for COBRA coverage. They are required to notify her that a qualifying event has occurred. She will have time to elect this coverage following the coverage end date. Electing this coverage is a important when you have critical health issues currently being covered. Basically you keep the same coverage and policy as before, but now you are picking up the amount of the total premium plus administration costs. There are limits on the cost of the premiums plus administrative costs. The great thing about COBRA coverage is that they will not consider any of the covered conditions being treated as pre-existing conditions. COBRA falls under the HIPPA (Health Insurance Protection and Portability Act ?). This Act also allows you to transfer from one group coverage to another without letting such illnesses being treated as pre-existing. So if she takes COBRA coverage starting in July and later decides to change employment....the condition will not be considered pre-existing under the new plan if it is also a group plan...or maybe by then the employer will change their coverage to allow her to be considered for this coverage again. Unfortunately, many employers are making changes to who they cover due to the significant increasing costs of insurance for employees. Some companies are still covering employees but are dropping family coverage, or making the employee pick up 100% of that cost and not allowing coverage of dependents that are eligible for coverage elsewhere. Just wanted to offer some basic info. I work with audits of employee benefit plans. COBRA is a great option...costs a little more, but it protects future coverage in a way that switching plans probably wouldn't.

[dairy mom]

What a dilemma.   I have a question soilbabe.  Exactly what in the health care reform would trigger employers doing something like this.  I must say I have not followed the debate on health care much.  Figure it really didn't affect us very much being self  employed and purchasing insurance on our own.  Besides from the little I did absorb about the debate nothing was being done about the cost of insurance or medical care which is what the reform should have been about.

Also why put the responsibility for such actions on the reform rather than holding employers responsible for harmful decisions toward their employees?

Also Chick06 I hope your grandson continues to get the care he needs.

I positively hate insurance companies.  When my mother was being treated for multiple myeloma there was a snafu with insurance and her age and the doctor not accepting the coverage she had to change to which I believe whole heartedly shortened her life by many years. 

[turkey feather]

Some good advice here. Cobra in my state is very expensive but does give you continued coverage for a period of time. I think she should check out working more hours to qualify for the coverage. Do not let the coverage stop, switch to COBRA if necessary! Once there is no coverage he will become un-insurable, of course.

[Ruby Lou]

Call your congressman.  I don't know what they can do, but let them know the situation and tell them the hardship it is causing.

[ABCD Farmer]

Does she have the option to work the extra hrs. to remain covered?  I totally understand that she would not want to spend anymore time away from her son than she has to.

[Kay/NC]

Hopefully, she can find a way to work it out through her current employment situation.   From what you described, there are probably quite a few nurses asking for an extra shift assignment now. 

I am not so sure her plan to just buy another policy will really work, since he has a pre-existing condition.  I am nto sure exactly when they are no longer allowed to deny coverage on that basis, but some parts fo teh health caer bill do not kick in until 2014. 

They need to get into a group policy situation, if the hospital doesn't work out well.  It is unlikely that he'll get coverage wihtout a rider for his tumor, on individual or family coverage.  Are there any other groups they belong to that carry potential group policies that they could subscribe to? 

For example, Farm Bureau used to offer group plans, but in NC at least now, all policies are individual, and they administer them for their clients.  In some states, NFIB has health insurance policies, and maybe her self-employed husband could join and enroll them there. 

This is why I mentioned a parttime job somewhere like Home Depot...some really big companies offer their parttime employees health coverage, too.  Usually only takes a shift a week.

Also, she may have some luck finding help if she talks with the people who manage billing at the hospital.  They know who pays what, and might be able to point her in a good directionj, with specific knowledge of who insures in your area. 

I still think COBRA may be her best bet, since it is the same policy with the same company, just paid for by the employee instead of the employer at the switchover.  The shoudl eliminate any concerns over-existing conditions. 

I asked my former vanguard friend in class today.  She said to look into COBRA, the SCHIP program for your state, and to look into any potential special funds from Medicaid, since they sometimes offer some coverage for certain conditions in children. 

I'll keep checking into any angles that I can find out about.