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Health Insurance: Stay Protected Amid Layoffs, Budget Cuts

Insurance Regulators Offer Tips, Information for Consumers

KANSAS CITY, Mo., May 14 /PRNewswire/ -- With the national unemployment rate at 8.5 percent,(1) families are living on tighter budgets, and many are struggling to maintain their health insurance coverage. Despite these challenges, there are still ways for consumers to remain protected and save on insurance costs, according to the National Association of Insurance Commissioners (NAIC).

"These uncertain times require us all to be vigilant about our insurance to make sure we are protected," said NAIC President and New Hampshire Insurance Commissioner Roger Sevigny. "Consumers can safeguard themselves and their families regardless of their employment situation by making sure they understand their coverage and researching less expensive alternatives."

Options for the Newly Unemployed

It is important for the newly unemployed to examine their options early, because some choices expire within weeks of job termination. The NAIC offers the following tips about health insurance for those who have recently lost their jobs or believe they might need to plan for the possibility:

    *  If married, consider joining your spouse's plan: Transitioning to a
       spouse's plan is typically the most affordable option, but you have
       to act quickly. There is a 30-day special enrollment period during
       which an employee can add a dependent who has lost coverage. If that
       30-day window expires, then your spouse would need to wait to add you
       to his/her plan until the open enrollment period occurs.

    *  Consider COBRA: The federal Consolidated Omnibus Budget
       Reconciliation Act (COBRA) allows individuals who leave their jobs at
       companies with 20 or more employees to continue their health
       insurance coverage for 18 months. Many states extend similar access
       for those who worked for small companies through "mini-COBRA" laws.
       In most cases, you have 60 days to elect coverage. COBRA coverage can
       be expensive, because you are required to pay the full premium, plus
       an administrative fee. However, it is also retroactive once you elect
       it, so use those two months to evaluate other options. Those who lose
       their jobs because a company goes out of business might not be
       eligible for COBRA if the company stops its group insurance plan.

       As part of the newly enacted economic stimulus package, the federal
       government will pay 65 percent of COBRA extended coverage premiums
       for workers laid off between Sept. 1, 2008, and Dec. 31, 2009.
       Employers had until April 18 to notify former staff eligible for this
       option. There are income limits for subsidy eligibility, however:
       $125,000 for single adults or $250,000 for couples who file taxes

    *  Research eligibility for government-sponsored plans: Check to see if
       you are eligible for insurance through a government program, such as
       Medicaid or Medicare. For more information, visit or

    *  Purchase a private plan: You can purchase coverage through private
       providers if you meet certain criteria. A high-deductible major
       medical policy will cover serious or catastrophic health costs if you
       cannot afford a comprehensive plan. Just remember, these plans will
       require you to pay more out-of-pocket costs should you need medical

    *  Join a state-sponsored risk pool: For those who have been denied
       affordable health coverage from a private insurer because of a
       pre-existing condition, high-risk pools provide the option of
       purchasing a state-sponsored insurance plan. These types of plans can
       be an alternative for individuals who are not yet eligible for
       Medicare or for those who are temporarily unemployed and need
       insurance in the interim. Thirty-four states offer high-risk pools,
       but the terms of coverage vary by state. Check with your state
       insurance department to see if your state has a high-risk pool and,
       if so, what your options are. Go to the NAIC's Web site for a link to
       your state insurance department:

Maximize Existing Health Insurance Coverage

Those who have health coverage should also explore ways to take full advantage of existing benefits.

    *  Switch to generic prescriptions: If you are insured through your
       employer, your health plan likely provides a discount for generic
       medication. This discount can help you save on monthly out-of-pocket
       health costs. If generic options are not available for your
       medications, work with your doctor to help ensure your medications
       are listed among your health plan's list of preferred prescriptions.
       If a drug is not on the formulary, then there is higher cost-sharing
       (co-insurance or co-pay).

    *  Schedule an annual check-up: Annual physicals can catch health
       problems before they become serious, saving you money in the long
       run. Many insurance plans cover 100 percent of wellness care for
       routine exams, immunizations and diagnostic tests.

    *  Stay in-network: Before booking an appointment, verify that your
       doctor is included in your plan at preferred rates. Sticking to
       network providers helps ensure lower co-payments and out-of-network
       costs. If you need to have a procedure done at an out-of-network
       provider, research the costs and be prepared to negotiate the price.

    *  Use preventive benefits: Some employers offer a subsidized gym
       membership or nutrition program. Staying healthy and active will
       reduce your chances of needing costly high-risk medical procedures
       throughout your lifetime.

More Information

If you have questions or are confused about your insurance coverage, contact your state insurance department. Visit to find contact information for your state insurance department.

Get smart about your insurance needs. For more information about auto, home, life and health insurance options -- as well as tips for choosing the coverage that is right for you and your family -- visit

(1) U.S. Bureau of Labor Statistics

About the NAIC

Formed in 1871, the National Association of Insurance Commissioners (NAIC) is a voluntary organization of the chief insurance regulatory officials of the 50 states, the District of Columbia and five U.S. territories. The NAIC has three offices: Executive Office, Washington, D.C.; Central Office, Kansas City, Mo.; and Securities Valuation Office, New York City. The NAIC serves the needs of consumers and the industry, with an overriding objective of supporting state insurance regulators as they protect consumers and maintain the financial stability of the insurance marketplace. For more information, visit


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SOURCE National Association of Insurance Commissioners
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