Consolidated Omnibus Budget Reconciliation Act (COBRA)
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end. COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.
National Toll-Free Contact Center. Live assistance is available Monday through Friday from 8:00 a.m. to 8:00 p.m. Eastern Time by calling, 1-866-4-USA-DOL (1-866-487-2365), TTY: 1-877-889-5627 http://www.dol.gov/dol/topic/health-plans/cobra.htm
Employee Benefits Security Administration (EBSA)
The website offers a great deal of valuable information in both English and Spanish. EBSA is an agency whose mission is to protect the integrity of pensions, health plans, and other employee benefits for people. Toll-free hotline: 1-866-444-3272. www.dol.gov/ebsa
HealthCare.gov is a new consumer web site that provides transparency into the health care marketplace. Through HealthCare.gov, individuals will have more control over their health care as informed and empowered consumers. The easy to use website provides one stop shopping access to a wealth of information, including new consumer rights and benefits under the Affordable Care Act, a timeline of when new programs under the new law will come online and a new insurance finder that makes it easy to find both private and public health insurance options. http://www.healthcare.gov/
Insurance – “A Consumer’s Guide to Getting and Keeping Health Insurance in Minnesota”
Written in January 2006 by the Georgetown University Health Policy Institute, this 36 page guide describes your protections as a Minnesota resident when you seek to buy, keep or switch your health insurance, even if you or a family member has a serious health condition. It describes your protections under group health plans, individual health insurance and as a small employer or self-employed person. There is a 3-page summary of numerous state and federal laws (including the Health Insurance Portability and Accountability Act or HIPAA) and a chapter on Financial Assistance for Minnesota residents who cannot afford to buy health insurance. http://healthinsuranceinfo.net/
Minnesota Disability Health Options (MnDHO)
This is a program for people with physical disabilities who are eligible for Medical Assistance (MA) or Medicare. This program is there for you 24 hours a day, seven days a week. People with physical disabilities can choose to join MnDHO or stay in their current MA program. There is no additional cost to join MnDHO. To be eligible for MN DHO you must: 1) be between 18 and 65 years old; 2) have a physical disability; 3) be eligible for MA (including MA for Employed Persons with Disabilities) or both MA and Medicare; and 4) live in one of the following counties: Hennepin, Ramsey, Anoka, Dakota, Carver, Scott, or Washington. The program is administered by DHS along with UCare Complete (a health plan) and AXIS Healthcare (a care management organization for people with physical disabilities). AXIS Healthcare is a partnership between Sister Kenny Institute and theCourageCenter. The health plan assigns a health care coordinator to each enrollee to help with paperwork and getting health care and support services. MnDHO offers all MA and Medicare services (if you also have Medicare). The health plan also may offer services that are normally not covered by MA or Medicare, such as modifications to the home or vehicle, extended personal care attendant services, and others. To enroll in MnDHO, contact UCare Complete at 612-676-6500 or 866-457-7144. You can also contact your county Department of Human Services (only in one of the seven counties listed above). www.dhs.state.mn.us
Children’s Defense Fund and Children’s Defense Fund–Minnesota
The Children’s Defense Fund (CDF) is a private, nonprofit, nonpartisan research and advocacy organization supported by foundations, corporate grants and individual donations. They do not accept government funds. Using research and data, CDF focuses on educating others about the needs of the poor, of minority children and those with special needs. They encourage preventive investment before children get sick or into trouble, drop out of school, or suffer family breakdown. Their website has many informative resources including Minnesota county data, Minnesota Census Data and a Minnesota Legislative Scorecard. You can sign up to receive their newsletter or join their E-Advocacy Network. 651-227-6121 www.cdf-mn.org
Federal Earned Income Credit and the Minnesota Working Family Credit
The Earned Income Credit (EIC) is a special credit for low income working families that reduces the amount of federal tax you owe (if any). The credit is subtracted from the amount of tax you owe, so you pay less tax or get money back from the government. Even if you do not owe any tax liability, you might still get some money back. You must meet certain eligibility requirements in order to claim the credit. Taxpayers who qualify for the federal EIC qualify for the Minnesota Working Family Credit. For more information on federal tax credits and refunds and to see if you are eligible, call (800) 829-1040. For information on state tax credits, call 651-296-3781
The Minnesota Governor’s Council on Developmental Disabilities
The Minnesota Governor’s Council on Developmental Disabilities works toward assuring that people with developmental disabilities receive the necessary support to achieve independence, self determination, productivity, integration and inclusion into the community. One program that was created by this Council is the Partners in Policymaking leadership training program for adults with disabilities and parents of young children with developmental disabilities. The purpose of the program is twofold: To teach best practices in disability, and the competencies of influencing public officials. For more information go to www.partnersinpolicymaking.com Address: Minnesota Governor’s Council on Developmental Disabilities; 370 Centennial Office Building, 658 Cedar Street, St. Paul, MN 55155. Phone: 651-296-4018 or 1-877-348-0505. www.mnddc.org
Minnesota Supplemental Aid (MSA)
MSA pays people with low incomes who are elderly, blind, or disabled to bring their income to a set amount. Many people on MSA get SSI. MSA uses Social Security disability criteria. MSA has income and asset limits and applications must be made through your local county human services agency. The best way to find more information on MSA is to use Google and type in Minnesota Supplemental Aid. www.dhs.state.mn.us and look under “Economic Supports.”
For many families their child’s needs far exceed their insurance coverage. Many families have high co-pays and deductibles or limited coverage that may not pay for physician recommended treatments or services. There are options:
Public Insurance Options for Children with Special Health Care Needs and Disabilities: TEFRA is a Medical Assistance program for children under the age of 18 with disabilities. Eligibility for TEFRA is based on the child’s disabilities and NOT ON the parent’s income, although there is a parental fee based on the parent’s income.
To learn more about TEFRA: DHS Web-site
United Healthcare Children’s Foundation Grants– the United Healthcare Children’s Foundation is offering support to meet the needs of children nationwide with assistance grants for medical services not fully covered by health insurance. Parents and caretakers across the country will be eligible to apply for grants of up to $5,000.00 for health-care services that will help improve their children’s health and quality of life.
Examples of the types of medical services covered by the foundation grants include speech therapy; physical therapy and psychotherapy sessions; medical equipment such as wheelchairs, braces, hearing aids and eye-glasses, and orthodontic and dental treatments. To be eligible for the grants, children must be 16 years old or younger. Families must meet economic guidelines, live in the U.S. and be covered by a commercial health insurance plan. For more information, visit: www.uhccf.org
A Consumer’s Guide to Getting and Keeping Health Insurance in Minnesota: http://healthinsuranceinfo.net/mn.pdf
Errors and Patient Safety: www.ahrq.gov/qual/errorsix.htm
Medical, Family Support, and Educational Services Are Available for Exceptional Family Members: www.gao.gov/cgi-bin/getrpt?GAO-07-317R
Other Helpful Information
Minnesota Health Information Clearinghouse
Health Coverage Options
The Minnesota Health Information Clearinghouse provides information and publications on health coverage options. This information can be useful when consumers are looking for health care coverage in Minnesota. www.health.state.mn.us/clearinghouse/clhlthcov.htm
Emergency Preparedness for Children with Special Health Care Needs: To facilitate prompt and appropriate emergency care for children with special health care needs, the American Academy of Pediatrics (AAP) and the American College of Emergency Physicians (ACEP) have developed an Emergency Information Form which can be used as a tool to transfer critical information about these children. www.aap.org/advocacy/emergprep.htm