Maintaining your health insurance coverage can be a challenge when you suddenly find yourself unemployed. To provide a safety net for these workers, the federal government enacted the COBRA law. COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1986, allows workers who voluntarily resign, are laid-off or terminated for any reason other than 'gross misconduct' the right to continue coverage under their company's group health insurance for up to 18 months at their expense. If your former employer has a group plan with at least 20 employees enrolled who have worked at least six months, you may qualify for COBRA health insurance coverage. If your wife or child were enrolled under the company's group plan, they may also opt for COBRA continuation of coverage benefits even if you opt out of COBRA. Depending on the qualifying event, you and your qualified family members can enjoy COBRA benefits for as long as 36 months.
But COBRA continuation of coverage benefits is not cheap; you will have to pay up to 100% of the premiums plus a 2% administrative fee, which can eat up as much as 84% of the average unemployment benefit check. Of course, you can apply for assistance to pay your COBRA premiums under the American Recovery and Reinvestment Act of 2009, which will give qualified participants a 65% subsidy to pay premiums, but this will only last for nine months or until the end of your COBRA benefits period, if you elected to join COBRA late.
If your COBRA subsidy is about to run out, you can consider getting an individual health insurance policy for yourself and other family members as a way to make COBRA coverage more affordable. When selecting a private policy, you can choose between an HMO and PPO health plan. HMO and PPO are common health insurance terms for the main types of managed health-care systems. A Health Maintenance Organization (HMO) plan requires you to get all your health care service from providers who are members of the HMO network. Under an HMO plan, you will need to select a primary care physician who will be your main health services provider and will refer you to other specialists in the HMO network as needed. A Preferred Provider Organization (PPO) on the other hand, does not require you to get your care from health providers within the PPO network, but will penalize you if you choose to go outside the PPO network by paying for their services at a lower rate or not paying for them at all.
So what are the pros and cons of getting HMO vs PPO insurance? While both can be affordable, you should get an HMO if you care more about preventive care services and you don't have a preferred doctor. On the other hand, a PPO might be the better choice if the doctor you're already seeing is a member of the PPO network or you want some freedom to direct your health care since you can see any specialist you want as long as they are a member of the network.
This means you can continue your HMO and PPO health plan for a specified amount of time after losing your job- but do you have any clue how much its going to cost you?
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