Are you looking for a new job?
Before switching jobs, ask about the type of health plan offered by the potential employer, and compare it to your current plan. Ask about the premium you’ll pay under the new plan, whether you can continue with the same doctors, or whether you will have to see new ones.  It might not be worth taking a new job to get an upgrade in salary if the extra money you’ll be making will be eaten up in health insurance premium costs that you did not have in your previous job.

Are you thinking about retiring?
When you’re thinking about retiring, be sure you understand the policies governing your health care plan. Review your plan, and any documents you have received that modify it.  Also, request copies of any formal written documents that outline how your plan operates, and any other information on your employer’s policies on retiree health care benefits.  You may need to visit the HR department of your company several months in advance of retirement to make sure you know what you are getting into with health care coverage.

Although some employers continue to provide health care benefits to their retired employees, private-sector employers are not required to do so.  Another thing to consider is that federal law does not prevent employers from cutting or reducing health benefits under plans available to participants and their families, unless there has been a specific promise to continue them and that promise can be legally enforced. Many employees set aside money to use for any coverage gaps that may occur before becoming eligible for Medicare.

HIPAA and COBRA
When you are getting a new health care plan, generally HIPAA limits preexisting condition exclusions to a maximum of 12 months (18 months for late enrollees). HIPAA also requires this maximum period to be reduced by the length of time you had prior “creditable coverage.” You should receive a certificate documenting your prior creditable coverage from your old plan when coverage ends. HIPAA may also give you the right to purchase individual coverage if you have no group coverage available, and you have exhausted COBRA or other continuation coverage.
If you are covered under your employer’s health plan and you leave your job, lose your job, have your hours reduced, or get
laid off, and your employer’s health plan continues to exist, you and your dependents may qualify to purchase temporary extended health coverage at group rates under COBRA.  Divorce, legal separation, loss of dependent child status, the covered employee’s death, or entitlement to Medicare, may also give your covered spouse and dependent children the right to elect
continued coverage under COBRA.

Your plan must be notified of these events. Generally, COBRA covers group health plans maintained by employers with 20 or more employees. The group health plan is required to provide you with a written notice indicating your eligibility for COBRA coverage. If you are eligible, you will have 60 days from the date the notice is sent or from the date your coverage ends—whichever is later—to elect COBRA. If the employer is too small to be subject to COBRA, state law may require the plan’s
insurer to provide some continuation coverage.

If you are moving away to get a new job or to retire, you could face a dilemma is your former company’s health insurance is an HMO.  If they do not have doctors in their network in the area where you are moving to, you will likely have only emergency care coverage and not be able to have a doctor where you are moving.  If you have to have a prescription for medicine and you don’t have a doctor to write the prescription, you’ll be out of luck.  So buying coverage through COBRA would not benefit you much.  You might have to seek out a private insurance plan that will work in the area you are moving to.  At least that way you’ll have coverage until you get coverage under your new job or through Medicare.

 

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