Consumers should be wary of short-term health plans

Consumers looking for health insurance outside of the annual open enrollment period should be wary of short term health plans. These plans may be marketed as alternatives to Affordable Care Act (ACA) health insurance, but they could leave you without adequate coverage and facing financial penalties at tax time. 

Originally, short-term health plans were sold as a stop-gap measure until you could get real major medical coverage. After the ACA kicked in, people had many other options for coverage, but these limited plans were still being marketed to consumers as a viable alternative. However, short-term  plans do not count as 'minimum essential coverage' under the ACA - meaning you'll have to pay a tax penalty. They also do not cover the 10 essential health benefits, can limit your annual benefits to $100,000 or less, and deny you coverage for any pre-existing conditions. 

These policies are sold year-round, unlike ACA-plans that must be purchased during the annual open enrollment period, unless you qualify for a special enrollment. Some states allow for coverage to last up to a year and policies can be renewed. This effectively takes people out of the insurance pool that the ACA was designed to expand, leading to increased costs for everyone. 

In an effort to bring the limited short-term health plans back to their original purpose and to protect consumers, the federal government is proposing a regulation to limit the duration of these policies to three months and increase consumer awareness of their limitations.

Insurance Commissioner Kreidler agrees with this effort and sent a letter yesterday in support of the new regulation.

Learn more about Medicare at free event Aug. 6 in Kent

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Kent Senior Activity Center from 10 a.m. to 2 p.m. on Saturday, Aug. 6

You will learn about:

• Medicare parts A, B, C and D
• Your Medicare benefits and options
• How to get help paying for Medicare if you qualify

Find registration and parking information for this event.

Other resources:

• Find out more events on the SHIBA calendar. 

• Read more about SHIBA and how it can help you. 

Do you have Medicare questions? Call 1-800-562-6900.

Breastfeeding and insurance: learn your rights

This week is World Breastfeeding Week, when people from all over the world celebrate breastfeeding. It may surprise you to hear that there’s a connection between breastfeeding and insurance.

The Affordable Care Act requires most health insurance plans to provide breastfeeding and lactation support, equipment and counseling to women during and after pregnancy as long as they are breastfeeding.

• While insurers must cover breast pumps, plan vary by what type of pump they cover, if they help pay for a rental or purchased pump, and if the pump needs to be pre-authorized. Contact your insurance company to find out what your plan covers. 
• Insurance plans must also cover lactation support for mothers and babies who are having trouble with breastfeeding or pumping. 

According to womenshealth.gov, babies who are breastfed have lower risks of many health conditions including asthma, ear infections, SIDS, type 2 diabetes and respiratory infections. Breastfeeding also benefits mothers’ health, promotes infant-mother bonding and is more economical than buying formula.

Find more information:

• Breastfeeding benefits: – Healthcare.gov 
• Breast Pumps and Insurance Coverage: what you need to know – U.S. Department of Health & Human Services 
• Breastfeeding a sustainable solution – The Olympian 

Read more about women’s health insurance rights on our website. Questions? You can contact our consumer advocates online or at 1-800-562-6900.

Consider your options when you lose your employer-sponsored insurance

Finding out you are being laid off is stressful, and in addition to that, you have to make important decisions about health insurance that can save you—or cost you—thousands of dollars at a critical time. It’s important to consider all your options when deciding between COBRA or buying your own plan.

What is COBRA? COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, which is a federal law that allows you and any of your immediate family members to stay on your employer’s health plan under certain circumstances :

• You lose or quit your job 
• You get a divorce 
• The employee dies 
• You are no longer covered as a dependent due to your age

Only employers with 20 or more workers in the previous year are required to offer COBRA coverage. State and local governments fall under COBRA, but the federal government and certain religious organizations do not.

COBRA can be expensive. People who choose COBRA coverage must pay the entire premium, including the portion previously paid by the employer, plus a 2 percent administrative fee. Be warned, if you enroll in COBRA and later on want to switch to a health plan directly to an insurance company or through the Washington Healthplanfinder, you will have to wait until the next open enrollment period if you don’t qualify for a special enrollment.

Options other than COBRA
Before you decide to go with COBRA, find out if you can buy a health plan through the Washington Healthplanfinder and receive a subsidy to help pay your insurance premiums. You can also purchase coverage directly from an insurance company, broker or agent if you don’t qualify for any subsidies.

If you choose a health insurance plan, you likely will be responsible for a full yearly deductible. Generally, health insurance deductibles are not prorated for partial-year enrollees, no matter how few months are left in the plan year. Individual or family qualified health plans operate on a calendar year, from January through December. There is no way to transfer the money you spent toward another plan’s deductible when you switch plans mid-year.

Read more about losing your health insurance on our website. Questions? Contact our consumer advocates online or at 1-800-562-6900.

For COBRA- specific laws and questions, contact:

U.S. Dept. of Labor, Employee Benefits Security Administration

Seattle District Office

300 Fifth Ave., Ste. 1110

Seattle, WA 98104

206-757-6781

Learn more about Medicare at free event July 9 in Seattle

Are you new to Medicare? The Office of the Insurance Commissioner’s Statewide Health Insurance Benefits Advisors (SHIBA) will be at the Seattle Central Library from 11 a.m. to 1:30 p.m. on Saturday, July 9.

You will learn about:
• Medicare parts A, B, C and D
• Your Medicare benefits and options
• How to get help paying for Medicare if you qualify

Find registration and parking information for this event.

Other resources:
• Find out more events on the SHIBA calendar.
• Read more about SHIBA and how it can help you.
• Do you have Medicare questions? Call 1-800-562-6900.