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COBRA Health Insurance
Health Insurance
How COBRA Works
Davis was terminated from his employment because of long absence from work and not because he voluntarily resigned or any gross negligence on his part. Therefore, he and his family are eligible for health insurance coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) provided his company maintains its group health plan and still has 20 or more employees for which they currently have 100. If his former employer were to have fewer than 20 employees, then he might still be eligible for what is called mini-COBRA. The COBRA Act was put into law...
The Act allows for the unemployed individual to avoid any gaps in coverage that would prevent them from having pre-existing conditions excluded once they were able to obtain group health insurance again, which is also addressed under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Calder, 2005, p. 56-57). This would be extremely important to Mr. Davis being he suffers from sickle cell anemia and requires frequent medical care.
The premiums; however, for COBRA coverage can be quite expensive for those who are accustomed to paying a portion of their premium with their employer paying the remainder. However, this coverage may be less expensive than Mr. Davis obtaining private health insurance in light of his chronic condition, which would allow the insurer to impose a higher rate to cover him. The former employee under COBRA will be responsible for 102% of the cost to retain group plan health insurance. The extra 2% is charged to cover administrative costs while under this coverage. If Mr. Davis has not obtained new group health insurance…
Challenges Facing the State or Local Government
It has been estimated that 46 million Americans were uninsured in during 2006-2007 (Gulley, 2011 p. 368). Chronically ill adults often require expensive health care services, which put a drain on available resources available to provide health care to uninsured, low-income individuals. When these adults forego the care they need, they become sicker and will then require increased health services, which will incur additional expense. These expenses need to be covered somehow and under the law; hospitals cannot refuse to provide treatment to individuals who are in need of emergent care to save the life of or to stabilize a critically ill patient. State governments are required to fund programs such as Medicaid, which provides coverage for low-income persons who cannot afford to pay for health care. Individuals with chronic health issues that require extensive medical care cause a drain on that system. Studies have also shown that patients on Medicaid often are underinsured and receive a poorer quality of care, which has raised mortality rates among those individuals (McWilliams, p. 479).
A solution to providing better coverage to chronically ill patients would be to reform health care through the Affordable Care Act at the state level by opening up the availability of state-sponsored health insurance programs such as Medicaid. The state's have the option of receiving extra funding from the federal government, however some have chosen not to receive it. (Jacobi, 2011, p.69). In the case
Healthcare Organization and Finance Scenario Medicare covers healthcare services such as surgeries, laboratory testing and doctor visits. It also covers supplies such as walkers and wheelchairs. These services and supplies must be considered as indispensable in the treatment of a certain disease or condition (King, 2009). Therefore, the expenses related to the walker that was prescribed to Mrs. Zwick after her discharge would be fully met in this section of the Medicare. Essentially,
Health Management (Discussion questions) First student The Emergency Medical Treatment and Labor Act (EMTALA) is a law governing how and when patients may be denied treatment or moved from one hospital to another in cases of extreme medical conditions. EMTALA was legalized as a component of the 1986 consolidated budget reconciliation (Richards & Rathbun, 2009). Sometimes, it is known as the CONRA law. This generalized name has generated other laws. A common
Health Care Reimbursement and Billing Both Mrs. Zwick and Mr. Davis face significant issues in the presented scenarios. Mrs. Zwick has multiple considerations under Medicare Parts A, B and D, in addition to her hospital-acquired urinary tract infection. Meanwhile, Mr. Davis must address the severe time constraints and costs of COBRA in light of his job termination. These two scenarios underscore current difficulties and complexities of current health care in the
Healthcare System My current healthcare plan is through Aetna via my husband's work. It is through a company, so the cost is drastically less than a private plan. Husband's employer Out of Pocket Costs: In Network Co-Pay: $ In Network Deductible: $500 Out of Network Deductible: $1,000 Percentage of Coverage: 100% after deductible is met, some percentages do apply for out of network providers, but Aetna does not give a specific amount. Aetna does have many limitations placed
According to Zoller, scholars and/or practitioners proponents of workplace health promotion (WHP) generally assume that employees universally welcome the programs. Perhaps, the primary delimitation that could be contributed to health and wellness programs would be that one of the other would not be wanted by employees. Consequently, health promotion literature that deems the programs to be "pro-social" endeavors designed in employees' best interests frequently fail to engage employees' participation. Additional delimitations
rights EMTALA grants, to whom, when, and in what setting. EMTALA is short for the Emergency Medical Treatment and Active Labor Act. It was part of the larger Consolidated Omnibus Budget Reconciliation Act of 1986, which is commonly referred to as COBRA. The EMTALA legislation governs how and when a patient may be refused treatment and/or when they may be transferred from one hospital to another while in an unstable