What others are saying about The Healthcare Survival Guide
“This slim book ... is written for the unemployed but includes tips for anyone trying to navigate the healthcare system. Its strength is in its timeliness.”
—The Washington Post
“It's tough to remain optimistic in this economy, but this slim book offers a glimmer of hope.”
—CBS 5, San Francisco
“[The Healthcare Survival Guide] can help people dealing with medical insurance problems.”
—NBC 10, Philadelphia
“Tricks consumers might employ…”
—Los Angeles Times
“[The book] is very good. I think it does do the right thing.”
—Case Western Reserve University, J.B. Silvers Ph.D., Treuhaft Professor of Health Systems Management
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The Healthcare Survival Guide
Cost-Saving Options for the Suddenly Unemployed
and Anyone Else Who Wants to Save Money
Martin B. Rosen and Abbie Leibowitz, M.D.
Smashwords Edition
Copyright 2010
This book is available in print at Amazon.com.
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the publisher.
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Preface
The title of our book, The Healthcare Survival Guide is no accident.
In the worst economic downturn since the Great Depression, millions of Americans have lost their jobs and their employer-paid health insurance. This has further swelled the ranks of the uninsured who are literally struggling to survive the complexities of our current healthcare system.
Simply put: Skyrocketing healthcare and insurance costs are increasingly placing healthcare services out of reach for more and more Americans. Despite the more than $2.3 trillion we spend annually for healthcare as a nation, a growing legion of individuals and their family members are forgoing needed medical care and medications, skipping routine checkups, neglecting vital preventive screenings and immunizations, and more. It is an especially dire struggle for those who suffer from pre-existing conditions, such as diabetes, heart disease, asthma, cancer, and other serious diseases.
The situation is bound to worsen as the formidable baby boomer population becomes eligible for Medicare—which itself has a range of limitations—and medical needs boost the costs even higher.
We’ve written this book to provide immediate information all in one place about affordable and, often, little-known healthcare resources. While we cannot provide all the answers, our goal is to provide Americans with information to help them safeguard their health now, when they need it most.
As we write this, our nation’s leaders are debating reforming the healthcare system. While we cannot predict how this debate will conclude or what the future of healthcare reform will hold, it is clear that people will still need help to access resources and understand health insurance options. We believe that our experience helping millions of Americans navigate the healthcare system provides important insights that can help people today and in the future.
Our perspective is very straightforward. With the goal that healthcare becomes affordable, transparent, and accessible, we hope a book to help Americans “survive” the system will become unnecessary. And our mission to help them “thrive” within it will rise to even greater importance.
Acknowledgments
A book of this scope and urgency could not have been produced without a dedicated team approach.
Our editorial and research team headed by Marcia Holman and assisted by Sara Savage spent many hours to locate, research, and verify the very best and latest resources that individuals can really use now. Robert Boston created the book’s unique, crisp, and lively design. Dawn Anderson and Jonathan Levine developed our companion website to provide updates to the book.
We would also like to acknowledge the critical feedback from colleagues who read various drafts to help make the book a better one.
This project would not have been possible without the support and encouragement of our company partners, Mike Cardillo, David Rocchino, Tom Masci, and Dan Messina, and the hundreds of men and women who work at our company serving the millions of Americans who use our service.
We want to also thank our families who were our biggest source of inspiration for this project and for their continued support of new and important challenges.
And finally, if those who read this book and visit our supporting website learn something that helps them receive the healthcare they need, all of the hard work that went into this project will have been more than worth the effort.
Martin Rosen ● Abbie Leibowitz, M.D.
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The Healthcare Survival Guide
Cost-Saving Options for the Suddenly Unemployed and Anyone Else Who Wants to Save Money
Preface
Introduction
Chapter 1: A Lifeline to Healthcare Survival
Chapter 2: All about COBRA
Chapter 3: Government Programs
Chapter 4: Comparison-Shop for Coverage
Chapter 5: Little-Known Cost-Cutting Strategies
Chapter 6: Keep a Watch on Medical Bills
Chapter 7: Best Ways to Get Drugs at a Discount (or Free!)
Chapter 8: Take Charge of Your Health
Chapter 9: Discover Health Advocacy
Chapter 10: Advocacy in Action
About Health Advocate
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Lost your job and your health insurance?
Here are low-cost options to keep you afloat until your next job
When you lose a job and your employer-based health insurance, it can feel like being set adrift in a stormy sea without a compass. Safe harbor gone, it’s hard to know where to find the resources to protect your health. Who will cover your doctor visits? How will you pay for medications? What if you get really sick? How will you handle a hospital bill?
This guide can provide a beacon to show you that options do exist, if you know where to look and how to use them.
As founders of the nation’s leading independent healthcare advocacy company, which has helped millions of Americans through the healthcare maze, we’ve written this guide for anyone who has suddenly lost their employer-based health insurance. Here you will find practical, easy-to-read information for locating—and using—affordable healthcare options to secure the healthcare insurance and services so important to protecting your health—and your family’s health—until your next job.
The book can also be an important resource for employers to help employees leaving their companies find healthcare options.
How will you get coverage? We help steer you to the answer
Finding your way through health insurance options, the confusing lingo, the different stipulations, and, most important, the cost differences, can be a daunting, dizzying task.
Chances are, as an employee, you relied on your Human Resources department’s benefit booklets to spell out coverage options. You checked a box, enrolled in a plan, and got coverage.
All that’s changed. Now it’s time to be an informed consumer and a savvy comparison shopper to hunt for and select the plan that fits your budget, your health, and your expectations.
We’ve done the legwork for you. We explain what you need to know to consider government, private, and individual health plans, and we provide the resources to help you access them quickly.
Of course, this guide is intended to provide general advice. It’s not possible to anticipate every possibility, and there are important exceptions to some of the rules described in the guide. It is important to consult your personal advisors in any situation that involves your health or finances. This guide can provide you with the first steps.
How to get discounted—but quality—care?
You will discover how to negotiate fees with your doctor, uncover low-cost medical services in your community, learn ways to reduce hospital expenses, find low-cost or free medications, and more.
Finally, we’ve included a section on how to keep yourself healthy through regular exercise, a good diet, and other lifestyle measures. These strategies can help keep you out of the doctor’s office and keep your expenses low.
For employers faced with the realities of the current economic climate, this guide can provide a relevant and important resource for their employees.
Keep in mind that as job losses continue and more people are seeking coverage options, new—and sometimes revised—information is emerging all the time. Websites and phone numbers may have changed from the time of publication. You may need to contact the specific organization that interests you to get updated information.
With this guide by your side, you’ll have a solid lifeline and real help to find the healthcare resources you need—when you need them most.
The authors are cofounders of health advocate, inc., which funded the publication of this book. The authors and the publishing company have received no funding from any other outside source or any other organization referenced in the book. a portion of the book sales will be donated to charity.
P.S. Communicate with us and stay updated
Our ultimate goal in creating our comprehensive guide and companion website is to help all Americans in need of healthcare resources become aware of the many options available to them.
We realize that healthcare information and resources are ever changing. And, as the healthcare reform proposals find their way into law, it is likely to impact some of the information provided in this book. This is why we have also created a website to provide important updates and which can also serve as a valuable meeting place. We hope that the website becomes a forum to share and exchange information, ideas, and suggestions.
Some of the most useful information comes from people on the front lines. Check in with us frequently, share your thoughts, and keep the dialogue going!
Email us at: info@healthcaresurvivalguide.com
Visit us at: http://www.healthcaresurvivalguide.com
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Chapter 1: A Lifeline to Healthcare Survival
Here’s how this guide can help you chart your course to the healthcare you need.
Consider COBRA
COBRA can be a temporary safety net. Only you can decide whether electing it is right for you.
Look into government-sponsored programs
Government-sponsored programs can be low-cost or even free. Find out whether you qualify.
Comparison-shop
Not all private health insurance plans are alike. Weigh them carefully.
Uncover cost-cutting strategies
Trim doctor fees, visit free clinics, and more.
Keep a watch on your bills
Are your doctor or hospital charges correct?
Take charge of your health
Eat better. Exercise more. Stop smoking. Reduce your level of stress.
Discover health advocacy
Get real help to navigate the maze.
Get drugs at a discount
You may not have to pay full price for your medications.
Updates available http://www.healthcaresurvivalguide.com
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Chapter 2: All about COBRA
Is this safety net coverage right for you?
When you lose your job, the first healthcare option you are likely to hear about is COBRA, which stands for “Consolidated Omnibus Budget Reconciliation Act.” COBRA generally applies to private-sector employers with 20 or more employees. If your former employer falls into that category and if you had employer-provided health coverage on the day before you terminated employment, your former employer must explain to you that you are entitled to elect temporary continuation of the same group coverage you had when you were employed.
At this printing, under the new COBRA legislation enacted in February 2009, the government will temporarily pay a portion of the premium. This could make COBRA coverage a more affordable option for you, at least temporarily. Here’s the shorthand version of what you need to know.
What is COBRA?
COBRA provides temporary health insurance continuation rights to terminated employees for a period of 18 months. It offers terminated employees and eligible family members the opportunity to continue the coverage they received from their employers. Under new regulations, the government will pay up to 65 percent of your premium, if you qualify. You are responsible for the remaining amount due.
COBRA premiums can be lower than the cost of some private individual health plans, especially if you or a family member has a pre-existing condition. Additionally, since COBRA coverage is identical to the coverage offered by your employer, it may be easier for you to use.
Eligibility
Who is eligible
Employees and their spouses and dependent children are eligible for up to 18 months of COBRA coverage if:
The employee worked for a company with 20 or more employees.(Note that state-required “mini-COBRA” may be available for individuals who were laid off from companies with fewer than 20 employees. For details about coverage and specific rules, visit your state’s website homepage and search for “mini-COBRA” benefits.)
The employee involuntarily or voluntarily lost their job (except for reasons of “gross misconduct”).
The employee’s hours were reduced to the level at which they are no longer eligible for health benefits.
Who else may be eligible
Retired employees and their spouses and dependent children may qualify.
Any child born to or adopted by a covered individual qualifies as a COBRA beneficiary.
Some independent contractors and others participating in group health plans may be eligible.
Who is not eligible
Employees laid off by a company that closes or goes bankrupt are not eligible. However, those who become retirees after a company goes bankrupt are eligible for COBRA for one year after the bankruptcy filing.
Employees whose employer ceases to offer any health benefit programs to its remaining active employees are not eligible.
The COBRA countdown:
Within 30 days of termination or benefit loss …