Editor’s Preface: The new American Recovery and Reinvestment Act (ARRA) is a revolutionary step in addressing our most vital economic challenges. A significant portion of the money doled out by the ARRA ($59 billion) will go towards immediately addressing the health crisis. This is the second part in a two-part series on subsidies for COBRA in the ARRA. We have also extensively covered this subject in “COBRA Health Coverage in a Bad Economy” and “Stimulus Package and COBRA Health Coverage.” You can find Part 1 of this series at: “COBRA Health Subsidies and the Economic Recovery Act“

COBRA Subsidies and Your Health Insurance

Knowing who is and isn’t qualified for this 65% COBRA subsidy coverage can get a little sticky. The ARRA only provides the subsidy to AEI, or “assistance eligible individuals.” Who qualifies as one of these special AEI’s? Anyone who is eligible for COBRA coverage on or before September 1, 2008 or on or after December 31, 2009. This is an interesting way of looking at things, because wouldn’t it just be simpler to say anyone on or after September 1, since December 31 falls after that date? Moving on. An AEI is also someone who chooses to use COBRA during the original COBRA period, or during a special period of coverage. Just what is a special period of coverage? This special election period begins on the date of enactment of the ARRA and ends 60 days after the person’s health plan administrator provides the required notice to the individual. You also have to be covered by COBRA via an involuntary termination (covered in my last post) by your former employer’s health insurance coverage plan.

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Editor’s Preface: The new American Recovery and Reinvestment Act (ARRA) is a revolutionary step in addressing our most vital economic challenges. A significant portion of the money doled out by the ARRA ($59 billion) will go towards immediately addressing the health crisis. This two-part series by Tara Barnes will delve into the benefits of the stimulus package’s COBRA subsidy. We have also extensively covered this subject in “COBRA Health Coverage in a Bad Economy” and “Stimulus Package and COBRA Health Coverage.”

It cannot be denied-COBRA is a huge topic in the United States right now. People are up in arms about COBRA coverage (as can be seen from response here on previous blog postings) and some significant changes and new legislation put into place by the Obama administration may change the face of COBRA.

Spending in the ARRA for Health Insurance and Care Compared with Other Sectors

The ARRA (the American Recovery and Reinvestment Act) was signed on February 17, 2009 and directly affects the COBRA continuation coverage rules. Because so many Americans are upset with the way COBRA coverage works, will these changes benefit or hurt those who need to rely on COBRA to keep their health insurance? Are these new changes really going to make a difference in the things that citizens are frustrating about, like the monthly cost of COBRA? Read on to find out about the new act passed and how it will affect COBRA for those people living in the real world.
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Sometimes you just need to get seen by a doctor, stat. Maybe you aren’t having an emergency like having a baby or cradling your severed limb in your hands, but things like a sprained ankle or a rapidly rising temperature require some fairly prompt attention. According to Health Net’s website, urgent care services are “medically necessary services which are required for an illness or injury that would not result in further disability or death if not treated immediately, but require professional attention and have the potential to develop such a threat if treatment is delayed longer than 24 hours.” What is the difference between emergency and urgent care? How can you get seen quickly without spending a ton of your hard earned dollars? How can you make sure that your urgent care visit will be covered by your health insurance? Read on to learn the best way to approach urgent care.

Assess Your Symptoms

If you are feeling like you are having a heart attack, get thee to an emergency room, stat. Urgent care centers are not for people who feel like their lives are in danger. But, if you’re uncomfortable from a minor sports injury or your flu feels like it’s just getting worse, an urgent center will be the way to go. Before you hop into a car to head for the emergency room or an urgent care center, ask yourself the following questions: Could I tolerate the way I’m feeling for another 48 hours? Do I want to spend less than $600 on a visit? Do I have the time to wait to be seen? If you answered “yes” to all of these questions, point your car in the direction of the nearest urgent care center.

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Maoist China during the period between 1958 and 1976 was one of the world’s widest users of public health posters and announcements. It was almost impossible to go anywhere in the country without seeing some form of health poster telling citizens to do a certain thing or not do a certain thing in the interest of public health. Then, unlike now, China had a nationalized health care system. Today, China relies on a variety of health care options, including employer provided coverage (known in China as laobao yiliao) and individual health insurance policies.

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You hear whispers of it on the wind, legends of time where one person saw one doctor, who knew all of their past ailments, and truly cared about their health and well being. This standard has seemed to have fallen by the wayside in the recent years, among all the chaos and hubbub of the current United States healthcare system. Doctors now get paid per patient they see per day, so crammed waiting rooms, curt visits and impersonal service have become the norm, and we have gotten so used to it that we haven’t even considered an alternate way of doing things. But take of your goggles of disbelief, because a more personal, cozy model of health care is being buzzed about.

What is the Medical Home Model?

Three years ago, the healthcare guru’s over at IBM started looking at what they were doing to improve the quality of life for their employees and realizing they were overlooking a crucial component: healthcare. After realizing this crucial change that needed to be addressed, the director of healthcare transformation at IBM, Dr. Paul Grundy, helped found the Patient-Centered Primary Care Collaborative (PCPCC). This coalition of large employers, consumer organizations and medical providers developed the Medical Home model, and its combination of old school patient care combined with the latest in medical communication technology makes this unique and optimistic proposal for healthcare. Under the Medical Home proposition, one doctor would act as a coach for the team of specialists treating one patient, including things like preventative, holistic and wellness needs. More time is spent with the patients in person than you are probably getting from your doctor now, and the doctor is accessible on the phone and via e-mail in addition to extended office hours and coordination of care across the entire medical team.

Advanced Technology and Medical Care

The sharing of a patient’s health information via an EHR, or electronic health record, is an integral part of how the Medical Home model works. An EHR can help to reduce errors, eliminate duplicate tests, highlight drug interactions, improve overall quality of care and reduce costs. This interweb of information can allow a patient to access a web portal to schedule appointments and check their lab results, patient registries and e-prescriptions. With the click of a mouse, information about a patient’s health can be shared across a network of healthcare providers, and patients can always stay in the know about their treatment, doctor recommendations and medications by hopping online or picking up the phone. Instead of wasting precious free time that most of us don’t have, you would be able to utilize the tools readily available to you in the form of your phone and computer to stay in touch with your physician. Doctors would get extra money for being available for the patients in odd hours, and offices can get a little bit more money by implementing the technological changes necessary to upgrade the office. Phone and e-mail consultations would be reimbursed.

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Read the Fine Print

As I’ve mentioned in another blog, it would be a pretty amazing feat to make it into your golden years without having at least one “pre-existing medical condition.” The human body just can’t stay in peak condition until the end of one’s life, so having some medical baggage is perfectly normal for a senior. Since long term care insurance policies are designed with the elderly in mind, they are a little more lenient than other types of insurance plans when it comes to covering pre-existing medical conditions. This doesn’t mean that they welcome everyone with open arms. You need to be aware of this, and get very clear with insurance carriers about what their pre-existing medical condition clause it, get it in writing, and scrutinize every word.

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