Financial Support

COBRA premiums can be incredibly expensive—up to 102% of what you and your employer were once paying together (and in some cases, this amount can be even higher)! But despite the cost, it can be really important to exhaust your COBRA coverage in order to be eligible for certain protections afforded by HIPAA and other laws. For more information on COBRA, you can contact the Department of Labor, Employee Benefits Security Administration at http://www.dol.gov/ebsa.

While there are financial assistance programs offered through some private charitable organizations that may be able to reduce the cost of COBRA premiums (some of which are available here: https://www.disabilityrightslegalcenter.org/about/documents/NationalFinancialAssistance2011.pdf), one option that may be available to help people pay for the costs of COBRA in certain states is the Health Insurance Premium Payment Program (“HIPP”). HIPP is a Medicaid program that pays for the private health insurance premiums for certain individuals with high medical costs.

HIPP programs are not offered in every state and eligibility requirements vary. Generally, to participate in a state’s HIPP program, an individual must qualify for Medicaid and have an existing medical condition that has been determined to be a cost-effective condition for the HIPP program. For more information on which states offer HIPP programs, please view our handout on the topic, here: https://www.disabilityrightslegalcenter.org/about/documents/NationalHIPP2011.pdf

Unfortunately, I really just need to have my seat belt moved to the other side of my seat. I don't really thing there are any used ones out there. This is going to involve some body work. I just don't have the money for this. My disability is such an odd ball..

It sounds as if your doctor is not a contracted provider under your insurance contract. If that is the case the doctor is not subject to the insurance company, the insurance company's rules, regulations, policies and procedures have no jurisdiction on the non-contracted provider. Therefore, the non-contracted doctor has no legal obligation to send a claim, receive payment from the insurance company, or appeal a denied or partially paid claim. Everything reverts to the contract between the patient and their insurance company. That contract requires the patient to submit their own claim, however they can decide to submit a claim but it is only as a courtesy to the member. If the doctor is contracted with your insurer they must submit your claim for you and this scenerio should be reported to your insurer.

Keep in mind if you are using a non-contracted provider you will be subject to higher out-of-pocket cost since they do not have a pre-negotiated rate with your insurer. PAF has a great publication on Usual, Customary and Reasonable Charges (UCR) a result from using an out-of-network provider/facility. http://www.patientadvocate.org/index.php?p=439

Thank you for your response. I actually met you last year at the Society of Integrative Oncology (SIO) conference. I am very well of the integrative therapies out there and teach it to my clients. In addition, I used to work at youcanthrive as a integrative patient navigator/health coach but the program is limited to 3 months. I was hoping that maybe there was something more long-term. As you know these services can become quite costly. The women I work with are all in an underserved community and would never be able to afford anything other than meditation or fitness in the form of walking where there is not cost at all.

I really enjoyed this session! Thanks Annie!!

Much continued success to you and all the work you are doing.