Health care access a problem for those who lose their jobs

Published 12:02 am Sunday, March 15, 2009

The Oregon Insurance Division has consumer advocates available to help Oregonians sort through options to keep health insurance if they lose their jobs. Call (888) 877-4894 to reach an advocate.

If you lose your job but your employer stays in business, a federal law known as COBRA allows most employees to continue their same coverage for a limited time. If your employer has less than 20 employees, Oregon has a similar law called state continuation.

In both cases, employees must pay the full cost of the insurance.

Not everyone, though can afford the COBRA premiums, and COBRA is not available if your employer closes.

However, there are some other options:

n If your spouse or domestic partner gets insurance at work, you may be able to add yourself and/or family members to that plan under a “special enrollment” (also called a “qualifying event”) without having to wait for the annual “open enrollment” period. Contact your spouse’s employer as soon as possible.

? Apply directly to an insurance company for an individual policy. The higher the deductible, the lower the monthly premium. Insurance company’s may be reject family members with pre-existing conditions.

People who are rejected for an individual plan may be able to the following:

? Buy a “portability plan” through the same insurer that offered their employer plan. These health plans cover pre-existing conditions as long as you apply within 63 days of losing employer coverage. To see if portability is an option for you, talk to your employer’s benefits administrator and/or the insurance company that offered your work insurance.

? Buy insurance through the Oregon Medical Insurance Pool, a state program that insures people who are rejected for private individual coverage because of medical conditions, who can’t get a private-sector portability plan or who are eligible for the federal Health Care Tax Credit program. Call (800) 848-7280 or visit www.omip.state.or.us

People who go more than 63 days without coverage may have to wait to have pre-existing conditions covered when they next obtain insurance.

In addition to these choices, you may qualify for health care or a subsidy to help pay for private insurance through one of several state programs, including the Oregon Health Plan. To obtain an application for the Oregon Health Plan, call (800) 359-9517.

Oregonians in low-income households also may qualify for food stamps, Temporary Assistance for Needy Families or other assistance. To find out, call Oregon SafeNet at (800) 723-3638 or log on to http://www.oregon.gov/DHS/index.shtml.

The Family Health Insurance Assistance Program helps pay the monthly premium for private insurance for adults and children who have been uninsured six months or longer. However, the program’s waiting list is first-come, first-served. If you think you will be without insurance for six months, don’t wait to put your name on the list. Because of limited funding for the program, it may be between 18-24 months before you receive an application for the program.

Call (888) 564-9669 or visit www.fhiap.oregon.gov.

Information provided by the Oregon Department of Consumer and Business Services