Insurance and Inflammatory Bo... Video Transcript

Participants

Bettina Gregory , Jaime Jamieson , Joseph Moynihan

Summary

Health insurance is important to everyone, especially people with inflammatory bowel disease (IBD). This panel discussion offers information on different types of insurance and advice on how to handle problems with insurance providers.

Webcast Transcript

BETTINA GREGORY: Hello. I'm Bettina Gregory, and welcome to our webcast. This is the second of a two-part series on advocacy and insurance issues relating to inflammatory bowel disease. This webcast is sponsored by the Crohn's and Colitis Foundation of America. In this segment, we're going to look at insurance information, including Social Security disability.

Joining me are Jaime Jamieson and Joseph Moynihan. Jaime is a registered nurse with Health Connections. That's a company that runs a telephone call center to help people verify insurance benefits and to help resolve disputes with insurance companies over medical reimbursement.

Joseph Moynihan is a health insurance consultant. He got involved in insurance issues following his own experience with ulcerative colitis. Joe has written about health insurance information for CCFA. We welcome you both, and thanks for joining us.

Joe, let's start with you. What is the best option for patients with IBD?

JOSEPH MOYNIHAN: In the United States, people that have group health insurance through their employer is the best possible option for a variety of reasons, but the two most important is: it's broad coverage, and it's cost-effective. There's usually an employer subsidy that allows for it to be -- health insurance remains to be a cost-effective benefit.

BETTINA GREGORY: Okay, now we're talking about people who have jobs, but in this day and age people very often change jobs, perhaps more than once, during their career. Does that health insurance benefit travel with them?

JOSEPH MOYNIHAN: Portability is a very important issue, and several years ago, 1996 to be exact, Congress passed the Health Insurance Portability and Accountability Act, otherwise known as HIPAA, and among its provisions, which are extensive, is what's known as a certificate of continuing coverage. And provided that you meet the eligibility requirements of your previous employer, that certificate can be presented to your new employer, and that new employer can't impose preexisting condition exclusions on you or a family member, spouse or dependent child.

BETTINA GREGORY: In other words, if you had coverage and you had IBD, and you're changing to a different insurance company, they cannot exclude you?

JOSEPH MOYNIHAN: That's right.

BETTINA GREGORY: Okay. Now, what happens if you lose your job and you don't get another one right away that has the group health coverage?

JOSEPH MOYNIHAN: There's another law passed in the '80s known as COBRA, or the Consolidated Omnibus Budget Reconciliation Act, and its primary ary focus is, when you leave or you terminate employment, you have extended coverage for a period of 18 months at the group rate. Actually, it's 100-102% of benefit cost.

BETTINA GREGORY: So you have to pay a higher premium?

JOSEPH MOYNIHAN: Yeah, you have to pay a higher premium than you're normally used to, but you have access, and you have 18 months to sort out what are you going to do next. So it is access, and you have coverage, and it's comprehensive, employer-based coverage.

BETTINA GREGORY: Joe, you've been talking about people who have jobs or are changing jobs, but what about the last resort for people who don't have a job and don't have private health insurance?

JOSEPH MOYNIHAN: Because health insurance is regulated in large part by states, you have to be aware of what the state requirements are for access to that health insurance. And states have addressed the issue by allowing Blue Cross Blue Shields, by virtue of their historical tax status, to underwrite the individuals that need individual health insurance.