Alabama Help With Medical Care For the Unemployed
No matter how you slice it, unemployment is hard on families. One of the first things to go may be your health care insurance, which is quite often provided to us by our employers. Making sure that you and your children have coverage for health care is important in the event of an emergency.
Medicaid can assist you in providing some healthcare coverages, as well as dental care when you’re no longer covered due to the loss of your job or benefits.
Coming directly from the Alabama Medicaid Coverage pages, here is what you can expect from Alabama Medicaid when you need to qualify for some medical coverage to get you through the tight times until you find a job.
For the most part, those who are on Alabama unemployment will qualify for Medicaid of some type, even if it is not prescription coverage.
Size of Family (annual income)
1 — $ 10,400
2 — $ 14,000
3 — $ 17,600
For larger families add $3,600 for each additional person
So, for example, using this guideline, 133% of the federal poverty level for a family of 3 would be an annual income of $23,408, or a monthly income of $1,951. With this income you would still qualify for some type of medical coverate under Alabama’s Medicaid program.
Additionally, quoted from the Medicaid pages
* Parents who receive benefits under Temporary Assistance for Needy Families (TANF), also know as TANF Alabama Cash Assistance, are automatically covered. Parents should also know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12 month period.
* Poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can also qualify for Medicaid.
If you need help from Alabama Medicaid you can http://www.familiesusa.org/economic-recovery.html
Cindy Adkins Said,
December 9, 2009 @ 10:06 am
I have tried to get info about the “Temporary optional Medicaid coverage for the unemployed”. I have called the Alabama Medicaid Office in Montgomery, talked to a live person and also someone at the call center. No one knows anything about this…..can you help? Thank you!
admin Said,
December 9, 2009 @ 10:30 am
Hello Cindy,
I might be able to point you in the right direction, I think the original post is now wrong based on another site…..
but hopefully this will help. Obama increased emergency funding to Corba. From this site http://www.familiesusa.org/economic-recovery.html
http://www.statehealthfacts.org/profileind.jsp?cat=4&sub=154&rgn=2
The Stimulus Bill:
What Does It Do for Health Care?
The American Recovery and Reinvestment Act, signed into law by President Obama on February 17, includes $87 billion to shore up state Medicaid programs. It also provides subsidies to unemployed workers to help them pay the premium to stay in their former employer’s health plan (COBRA coverage). These are significant victories, and we applaud them. But we suffered some setbacks along the way—the COBRA subsidy is available for only nine months, for example, and the new, temporary Medicaid option to provide health care to low-income unemployed workers was dropped. We have much more to do. Still, this is an exciting first step.
Below we describe more of the health care provisions from the American Recovery and Reinvestment Act:
* Provide a subsidy to help unemployed workers purchase their employer’s COBRA coverage. The 65 percent subsidy would be available for up to nine months for workers who lost their jobs between September 1, 2008, and December 31, 2009, and whose income does not exceed $125,000 for individuals and $250,000 for families. People who lost jobs at small firms and who receive state continuation benefits (sometimes called “mini-COBRA”) are also eligible for the subsidy. For more information, see Understanding COBRA and Mini-COBRA Premium Assistance and States Act to Help People Laid Off from Small Firms: More Needs to Be Done.
* Increase federal dollars for state Medicaid programs by $87 billion until the end of 2010 to support this crucial safety net program amidst rising demands. Some states that are burdened by particularly high rates of unemployment would get extra federal support. States will not be able to change their Medicaid eligibility requirements while receiving the enhanced federal matching dollars. More information l FAQs l Summary of CMS Guidance
* Encourage the use of electronic medical records, including the collection of data on race, ethnicity, primary language, and gender, health information technology (HIT), and comparative effectiveness guidelines in order to promote system-wide efficiency and more effective clinical treatment.
* Extend Transitional Medical Assistance (TMA), a program that allows families to maintain Medicaid coverage temporarily when they start a new job and earn income that would otherwise render them ineligible. TMA prevents families from being penalized for working.
* Continue the Qualified Individual (QI) program, which helps low-income seniors and disabled Americans pay their monthly Medicare premium.
++++++
Understanding COBRA and Mini-COBRA
Premium Assistance
The American Recovery and Reinvestment Act (the economic stimulus legislation) provides premium assistance to help involuntarily unemployed workers purchase their former employer’s COBRA or other continuation coverage. Under the Act, for up to nine months, eligible unemployed workers will need to pay only 35 percent of the total premiums to continue the health coverage that they had through their jobs, and the federal government will reimburse employers or health plans for the remaining 65 percent of premiums. People are eligible for premium assistance if they were (or are) laid off between September 1, 2008, and December 31, 2009; have annual income during this tax year that does not exceed $145,000 for individuals and $290,000 for families; have a right to continued health coverage under COBRA or another law; and are not eligible for coverage under another group plan (such as through a spouse’s employer) or for Medicare. People with adjusted gross incomes between $125,000 and $145,000 (or between $250,000 and $290,000 for joint filers) will need to repay a portion of the assistance that they receive, while people with incomes below $125,000 for single filers and below $250,000 for joint filers are eligible for full assistance with no repayment.
States Act to Help People Laid Off from Small Firms: More Needs to Be Done provides an overview of the new law and discusses actions that some states may need to take in order to ensure that workers losing jobs in small businesses will be able to receive the federal assistance.
What happens in December 2009 as the subsidy begins to expire?
People who began receiving the subsidy for their March 2009 COBRA premiums reached the end of their nine months of assistance on November 30, 2009. This means that, unless Congress extends the subsidy (it hasn’t yet), they must pay their full premiums for December and the following months to keep their COBRA coverage. Similarly, people who began receiving the subsidy in April will reach the end of their nine months of assistance at the end of December and will have to pay their full premiums for January to keep their COBRA coverage, and so on. Further, unless Congress extends the subsidy, people who are laid off and become eligible for COBRA after December 31, 2009, will not be eligible for the subsidy at all. For more information, see the Department of Labor’s “frequently asked questions†online at http://www.dol.gov/cobra.
People generally have a 30 day grace period after the first day of the month for which premiums were due to pay their COBRA premiums, but if the premiums are not paid by the end of the month, they may lose their right to further COBRA coverage. This means that people need to watch their premium due dates very carefully, since they may not get a notice that their payment is overdue until it is too late. If your subsidy has expired and you continue to pay the reduced premiums instead of full premiums, you could also get into serious trouble: According to current regulations, if people underpay their premiums by just a little bit, the plan must give them notice and 30 days to pay the full amount. However, if people underpay by a lot, current regulations do not require the plan to keep the COBRA coverage going. If you are in this situation, you should get in touch with the Department of Labor’s benefit advisors for guidance—call 1-866-444-3272.
Bills are pending in both the House and Senate to extend the COBRA subsidy. In the House, H.R. 3930, which was introduced by Representative Joe Sestak (D-PA), would extend the subsidy by six months (so that it lasts for a total of 15 months) for people who are laid off through June 30, 2010. In the Senate, S. 2730, which was introduced by Senators Sherrod Brown (D-OH) and Bob Casey (D-PA), would also extend the subsidy to 15 months for people who are laid off through June 30, 2010. In addition, it would also increase the amount of assistance from 65 percent of COBRA premiums to 75 percent. As of early December, it is not clear when or if these bills will come up for a vote, so you may want to keep in touch with your congressional representatives about the status.
What are COBRA and other continuation coverage laws?
COBRA is a federal law that allows people who leave jobs in businesses with 20 or more workers to continue receiving coverage through their former employer’s health plan, generally for up to 18 months (longer in some circumstances). The right to continue coverage applies to both workers and their dependents—a worker can elect to continue coverage for just the worker, the entire family, or just certain family members. Normally, people must pay the full cost of premiums (including both the employer and employee share) plus a small administrative fee of up to 2 percent of premiums. The Recovery Act provides up to nine months of premium assistance to people who are eligible for federal COBRA benefits, so that they will have to pay only 35 percent of premiums during that time.
People who lose state or federal government jobs are generally eligible to continue their coverage under other laws that are similar to COBRA. They will also be able to receive premium assistance.
Many states have laws known as “state continuation†or “mini-COBRA†laws. These laws help workers in businesses with fewer than 20 workers continue their health coverage if they lose their jobs. Such state continuation laws require small group health plans to provide continued coverage to unemployed workers as long as they pay both the employer and employee share of the premium. In some states, these laws mirror the federal COBRA law. In other states, they provide shorter periods of continued coverage or fewer benefits. In some states, workers who lose jobs in small businesses are not able to continue coverage under their former health plans at all. The Recovery Act will also provide premium assistance to involuntarily unemployed workers who receive continued coverage under state programs, but only those programs that are “comparable†to COBRA.
What should states do now?
States should make sure that they have a mechanism in place to enable workers who leave small firms to continue their health coverage so that these workers will be able to receive premium assistance. The law says that premium assistance will apply to “a State program that provides comparable continuation coverage [to federal COBRA].†(States are defined to include the District of Columbia and the territories.)
The following states do not currently require continuation coverage (mini-COBRA) for small businesses: Alabama, Alaska, Arizona, Delaware, Hawaii, Idaho, Indiana, Michigan, Montana, and Washington. (In Washington, insurers are required to offer employers the option of having a continuation coverage provision; however, continuation coverage is not mandated in group policies, so employers may offer plans that do not provide continuation coverage.) These states should enact laws that provide continuation coverage for at least nine months for people leaving jobs in small businesses, which would enable these unemployed workers to qualify for federal subsidies. (We do not have information on programs in the territories.)
* The following states have state continuation (mini-COBRA) laws for small businesses, but the laws currently provide only a short period of continued coverage for laid-off workers: Arkansas, Nebraska, New Mexico, Oklahoma, South Carolina, Tennessee, and Vermont. These states should extend their required periods of continuation coverage to at least nine months so that workers who lose jobs in small businesses will be able to get the full nine months of premium subsidies provided by the federal government.
* All states with continuation coverage (mini-COBRA) laws should amend their laws as needed to give workers laid off from small firms after September 2008 a new opportunity to enroll in the continuation plan now that premium assistance is available. (People who are eligible for federal COBRA will have a new 60-day opportunity to enroll. This will be important to people who could not afford COBRA before but who can afford COBRA with the new premium assistance.) States should make sure that people who take this second chance to enroll, and who have a gap between when they lost insurance and when they elect mini-COBRA, are not subject to an exclusion of coverage for pre-existing conditions.
* States should also determine if they can build on this new assistance program to provide deeper help to low-income unemployed workers. Even with the federal subsidy, some of these workers will not be able to afford their share of premiums. States may be able to assist with paying the remaining 35 percent of premiums for low-income unemployed workers. State Coverage Initiatives provides good suggestions for states about how to build a deeper subsidy at http://newsmanager.commpartners.com/ahstsd/issues/2009-02-27/2.html.
For more information, see States Act to Help People Laid Off from Small Firms: More Needs to Be Done.
Summary of Premium Assistance Provisions in the Recovery Act
Who’s eligible for assistance?
* People who were eligible for COBRA, state continuation benefits, or continuation of a federal or state employees’ health plan due to involuntary job loss between September 1, 2008, and December 31, 2009, and whose adjusted gross income does not exceed $125,000 for individuals and $250,000 for families are eligible for the full amount of premium assistance (65 percent of premiums).
* People with higher incomes—that is, people with adjusted gross incomes between $125,000 and $145,000 for individuals or between $250,000 and $290,000 for joint filers—can also get the subsidy, but they will need to repay a portion of the amount they receive.
* The subsidy can cover the worker and/or the worker’s spouse, partner, or dependents that had coverage under the health plan.
* Those who are eligible for other group health coverage (such as a spouse’s plan) or Medicare are not eligible for the premium reduction.
How will people with high incomes be kept from getting the premium assistance? Does the employer or health plan have to determine income eligibility?
No, the employer or health plan does not need to determine income eligibility. If a person with adjusted gross income above the limits listed above receives premium assistance, he or she will gradually repay it when filing his or her tax returns. Alternatively, the person can waive premium assistance so that he or she will not have to repay.
How will people get premium assistance?
People will pay 35 percent of the cost of their premiums to their former employer’s health plan. The employer or health plan will be reimbursed for the remaining 65 percent by deducting this amount from the quarterly employment taxes it would otherwise pay the federal government. If it is owed more than it can deduct, the employer or health plan will receive a refund or credit from the federal government. The employer or health plan must attest that each person receiving premium assistance was involuntarily terminated from a job.
Can people use the assistance for a cheaper health plan than they had when they were working?
If their employer offers more than one health plan to employees, the employer may (but is not required to) allow people receiving the premium assistance to switch to the lower-cost plan. However, the lower-cost plan must be a full health plan—it cannot be one that covers only dental, vision, counseling services, referral services, or care only at the employer’s on-site medical facilities, nor can it be just a flexible spending account. People have 90 days to switch plans after getting notice of this option.
When does the assistance begin?
The law says that, for any period of coverage after the date of enactment (February 17, 2009), COBRA coverage for an eligible individual is considered paid if the “individual pays (or a person other than such individual’s employer pays on behalf of such individual) 35 percent of the amount of such premium….” People who lost their jobs between September 1, 2008 and February 16, 2009 should receive notice from their employers or health plans by April 18, 2009, about how to enroll in COBRA and premium assistance. Coverage and premium assistance are generally retroactive to March 1, 2009. Consumers who encounter problems or questions about enrolling in COBRA with premium assistance should contact DOL at 1-866-444-3272.
What if someone pays full premiums after this law is enacted when they are entitled to the premium assistance?
For the first or second period that COBRA premiums are due after the law is enacted, if a person pays full premiums, he or she is entitled to reimbursement of the excess amount from the employer or health plan or to a credit toward future premiums.
What about people who lost jobs after September but before the law was enacted?
People who lost jobs after September but who did not elect COBRA before will have a new 60-day period to elect COBRA after they get notice about the available help. In addition, people who lost jobs and elected COBRA after September but who are no longer enrolled (presumably due to costs) also have a new election period. Their former employer or former group plan administrator has 60 days after the law is enacted to provide them with such notice. The Department of Labor has developed model notices for this purpose. It might take until April 18 for individuals who have already lost jobs to receive notice of their eligibility for help, and then they will have another 60 days to elect COBRA.
Will people be subject to a new pre-existing condition exclusion period if they did not elect COBRA until premium assistance was available?
No. The law does not count the period before assistance was available as part of a “break in coverage†that would subject a person to pre-existing condition exclusions.
How long does the assistance last?
The person will get help paying their premium until the earliest of the following:
1. They are eligible for another group health plan through an employer and can be covered under that plan. (They MUST notify the first plan at this time. If they fail to notify their health plan when they are eligible for other coverage and no longer entitled to premium assistance, they may be required to pay back the excess premium assistance plus a 10 percent penalty.)
2. They have received the subsidy for nine months.
3. Their COBRA period ends.
Will receiving premium assistance reduce other income-based government benefits?
No. Programs such as food stamps, energy assistance, etc. that provide support to people with low incomes are not allowed to count the COBRA premium assistance as income.
How will people find out about premium assistance?
Currently, when people leave jobs with 20 or more workers, their employer or health plan provides a notice about their COBRA rights. These notices will be modified to include information about COBRA premium assistance. The Department of Labor, Department of Health and Human Services, and the Treasury Department have developed notices for other employers to give to their employees about premium assistance for state continuation plans and continuation plans for government workers. The notices explain how to apply and whom to contact.
People who lost jobs after September 1, 2008, and who did not elect COBRA before the Recovery Act was passed will also receive notices from their former group health plan or health plan administrator informing them of the availability of COBRA premium assistance, whether or not they have already enrolled in COBRA.
Additionally, the Departments of Labor, Health and Human Services, and Treasury will conduct outreach and post information on their Web sites.
What if people are denied assistance—can they appeal?
If a person requests premium assistance for COBRA and is denied, he or she can ask the Department of Labor to review the decision. If a person requests premium assistance for state continuation benefits or continuation under a plan for government workers and is denied, he ro she can ask the Department of Health and Human Services to review the decision. The appropriate agency, in consultation with the Department of the Treasury, will make a determination within 15 days.
What data will be collected and shared with Congress about this program?
The agencies mentioned above that are charged with administering the program will provide an interim and a final report to Congress on the number of people receiving assistance and expenditures for the program, and the final report will include average monthly and annual payments made for individuals receiving the COBRA subsidy.
Where can I get more information
http://www.dol.gov/ebsa/COBRA.html.
[WORDPRESS HASHCASH] The poster sent us ’0 which is not a hashcash value.