If you lose your job or no longer have access to health insurance, you may still have options for continuing your health care coverage.

COBRA

If the company you worked for has 20 or more employees and you lost your health insurance coverage, you may be able to extend your group coverage under a law called COBRA (the Consolidated Omnibus Budget Reconciliation Act)*. COBRA allows you to temporarily continue your benefits exactly as they were under your employer plan including your out-of-pocket costs for medical care and any prescription drug, dental, or vision coverage. You must purchase the coverage at the same rate your employer paid for the plan, plus a two percent administrative fee.

If you lost your job on or after September 1, 2008, you may be eligible for a 65 percent reduction in the COBRA premium rate for up to nine months as a result of provisions within the recent federal stimulus package.

To learn more about the COBRA premium reduction, refer to the Department of Labor’s Fact Sheet: COBRA Premium Reduction.

More information is also available in a recent press release from the Pennsylvania Insurance Department entitled, “Pennsylvanians encouraged to take another look at COBRA options.”

* Qualifying causes for loss of health insurance include termination of employment, reduction in work hours, death of subscriber, loss of dependent status, divorce, or legal separation. If your employer is no longer in business, COBRA will not be available to you.

HIPAA Continued-Coverage Plans

These plans offer guaranteed coverage as described in the Health Insurance Portability and Accountability Act (HIPAA). This means that you may not be denied coverage in one of these plans because of a prior health condition. With our HIPAA plans you choose the level of coverage you need — from hospitalization, medical/surgical, and Major Medical plans. You may receive care from any hospital or doctor based on the coverage you choose. HIPAA plans do not cover preventive services.

To enroll in a HIPAA plan, you must no longer be eligible for employer insurance and have exhausted COBRA coverage. There is no preexisting condition exclusion as long as you had group coverage for at least 18 months prior and enroll within 63 days of terminating your previous coverage.

To learn more about pre-existing condition exclusions and what qualifies as a Blue-to-Blue transfer, review the Creditable Coverage FAQ.

Learn more about HIPAA Continued-Coverage Plans.

Conversion Plans

Keystone HMO Conversion Plans

If the coverage you had under your former employer was a Keystone Health Plan East HMO plan, you may have the option to switch to one of our Keystone HMO conversion plans. You may also be eligible for a conversion plan if you have exhausted your COBRA benefits.

There are two HMO conversion plans available. Covered benefits include:

• primary and specialist care;
• preventive care;
• hospitalization;
• emergency and urgent care.

The Keystone HMO conversion plans are similar to an employer-based HMO plan; you must select a primary care physician from our expansive network to coordinate all care. Vision, dental, and prescription drug coverage is not included in HMO conversion plans.

To learn more about Keystone HMO conversion plans, call IBC Customer Service at 1-800-ASK-BLUE (1-800-275-2583).

Personal Choice^®

If you no longer have coverage through an employer and want to continue your benefits with a PPO plan, we offer Personal Choice for individuals. With Personal Choice, you can receive care from any provider without a referral.

Covered benefits include:

• primary and specialist care;
• preventive care;
• hospitalization;
• emergency and urgent care;
• prescription drugs.

This plan is a “guaranteed coverage” plan, meaning that you may not be denied coverage in this plan due to a prior health condition. A preexisting condition exclusion period may apply, however. If you transfer directly from another Blue Cross^® and Blue Shield^® plan without a lapse in coverage, the preexisting condition exclusion period may be reduced or eliminated.

To learn more about preexisting condition exclusions and what qualifies as a Blue-to-Blue transfer, review the Creditable Coverage FAQ.

Learn more about Personal Choice.

To find out more about your options for health care coverage, call IBC Customer Service at 1-800-ASK-BLUE (1-800-275-2583).