He chose instead to continue coverage under Cobra — the Consolidated Omnibus Budget Reconciliation Act. The decades-old law lets people continue workplace health coverage for up to 18 months after leaving a job. But there’s a catch: You must pay the employer’s share of the monthly premium plus your own. So it’s typically expensive, Mr. Gilbert says in the video, admitting that he was a “big dummy” for using it.
Earlier this year, as Mr. Gilbert’s Cobra coverage was close to expiring, he reluctantly ventured back to the insurance marketplace and, after a week or so of reading documents, chose a health maintenance organization. The H.M.O. saves him about $200 a month — but offers less flexibility in choosing doctors than his former plan, a preferred provider organization, or P.P.O.
After that, he figured, he had “a basic understanding of health insurance,” so why not produce a video to help others? (In the video, after discussing P.P.O.s, H.M.O.s, and H.D.H.P.s — high deductible health plans — Mr. Gilbert smiles faintly. “Every word in that sentence,” he says, “burned as it came out of my mouth.”)
He expected to spend perhaps a month doing “a quick, eight-minute video.” But, this being health insurance, he kept learning of exceptions and caveats that required explanation, so the project stretched to four months. Since he isn’t an expert, he said, he stuck to translating terminology and sent a rough cut to supporters, some of whom have health insurance expertise, for accuracy and feedback. (Mr. Gilbert said he earns payments from patrons via the crowdfunding site Patreon and from ads that run with his YouTube videos. He said he wasn’t paid by health insurers.)
Mr. Gilbert said he’d been pleased that people have been watching the video, but stressed that he was not an insurance guru. Based on his experience, though, he offered this advice: “Focus on the thing most necessary for you and make sure that the plan deals with that really, really well.”
While the video is largely accurate in its descriptions, a segment on the unexpected bills that patients sometimes get for emergency room visits warrants an update (which Mr. Gilbert acknowledges in a comment on YouTube). The No Surprises Act, a law that took effect in January, enacted new rules to protect consumers against surprise bills for out-of-network treatment at emergency rooms.
Here are some questions and answers about health insurance:
When does open enrollment end for marketplace plans?
The HealthCare.gov deadline for coverage that starts on Jan. 1 is Dec. 15. (You can enroll until Jan. 15, but your coverage won’t start until February.) Seventeen states and the District of Columbia run their own exchanges and may have different deadlines. If you miss a deadline, you may qualify for a “special” enrollment period if you get married or lose your job. And some low-income people can enroll in marketplace plans anytime. Consumers can get assistance in choosing a plan by clicking on “find local help” on HealthCare.gov.
Source: | This article originally belongs to Nytimes.com
