Healthier and Wiser: Women Without Coverage Part II

Healthier and Wiser

Many people who have health insurance obtain it through an employer. However, there may be times in your life when you are without coverage, facing coverage choices or grappling with retirement health issues. The "Healthier and Wiser" series will address some of the main health care coverage issues women encounter at different stages of their lives. It will point you in the direction of where to go to find more information. It is not intended as legal advice. You can check out the "Healthier and Wiser" series on Wednesdays.

This Week: Women Without Coverage Part II

1. If you work part-time, can you qualify for health care coverage from your employer if you increase your hours?

• Employers don’t have to offer health care plans, and they are not required to cover everybody they employ. Most companies that offer health benefits require that you work a certain number of hours per year to qualify for health benefits, so it is worth finding out if changing your work schedule would make you eligible for benefits. It is often a smart financial move to increase your hours at your current job, or even change jobs if that is an option, in order to obtain health care coverage for your family.

2. If you are not working, or have a low annual income, what are your options?

• If you have lost your insurance due to loss of a job or a spouse, look into COBRA coverage. COBRA is a law that gives you the right to buy coverage in a workplace plan if you are no longer eligible to be covered under the plan as an employee or a dependent of one. You have 60 days to sign up for it through your previous employer or your spouse’s previous employer. Once you sign up for COBRA coverage, you will be allowed to stay in the plan for a specified time period, although you will be required to pay the full premium for coverage. Ask the former employer for more details about the options and benefits.

• Medicaid provides health coverage for low-income individuals and families. Low and moderate-income children can often be covered through the State Children’s Health Insurance program (SCHIP) and some state programs are now covering parents and childless adults as well. Call your state Medicaid office for more information.

3. If you don’t have health care coverage, can you negotiate fees with providers or do you have to pay whatever the doctor or hospital charges?

• If you don’t have coverage, always try to negotiate a price and/or a payment schedule, although providers have no obligation to accept your offer. You might offer to pay the provider whatever an insurance plan would have paid for your treatment, which would generally be lower than the provider’s “sticker price”.