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October 7, 2009 > Insurance Coverage Can Be Complicated

Insurance Coverage Can Be Complicated

Washington Hospital Seminars Can Help You Understand Your Options

With all this talk about healthcare reform, it's hard enough to know the details of your own plan. What does it cover, is there a premium, what about a deductible, can you get it for less? Do you really know if your health care coverage is right for you? Do you understand your options under Medicare Part D? And if you are unemployed, you may be wondering what to do next.

Fall is open enrollment for most large insurance plans as well as Medicare. So it's a good time to reevaluate your health insurance coverage and decide if you really have the best plan for you, according to Linda Dawal, health insurance information services coordinator at Washington Hospital.

"If you have lost your job, like so many in California, we can help you understand your options," said Dawal, who will present "Have You Lost Your Health Coverage?" on Wednesday, October 14, from 10 a.m. to 12 p.m., at the Conrad E. Anderson, M.D. Auditorium at Washington West, 2500 Mowry Avenue, in Fremont. To register, call (800) 963-7070.

The unemployment rate in California recently topped 12 percent, which has left many without health coverage. Dawal will discuss your options under COBRA, a government program that temporarily allows you to continue receiving health insurance through your former employer after you lose your job. While you have access to the group rate, your cost will most likely go up because you are responsible for the entire premium, she explained.

"The federal stimulus plan has made it easier for those out of work to keep their health insurance during these tough times," Dawal said. "For the first nine months, employers must pay 65 percent of the premium, which is a big help to those who are unemployed. After that, former employees pay 102 percent of the premium."

She will demystify the rules under COBRA so you can understand how the program works and what you can expect to pay. "There are also options for those who have lost their jobs that are less expensive than COBRA, so it's important to really know what is available. Healthy Families may be the way to go for some," Dawal said. "The seminar can help you figure that out."

Is Your Plan Right For You

"Insurance can be very complicated," she said. "A lot of people get confused when they start reading the fine print."

Dawal encourages consumers to take the time to really understand their insurance plans and what they cover. "People don't always have the coverage they think they have," she said. "Don't wait until you need it to find out it's not as good as you thought."

She also said life circumstances change our health care needs over time. "If you get diagnosed with diabetes, for example, your medical needs will change. Your health plan may not provide the best coverage for that," she explained.

People with Medicare Part D should also reevaluate their plans every year, according to Dawal. "There are 52 plans offered by private insurers under Medicare Part D," she said. "Those plans change. I want to help those with Medicare Part D stay on a plan that is the most cost-effective for them."

Dawal has several seminars scheduled in November to help seniors with their Medicare Part D enrollment. She has a computer program she uses to help people decide the best plan for them. She enters specific health information about each prospective enrollee into the database, including medications they take and health conditions. The computer program then identifies the best plans.

"It's just too complicated to sit down and compare by hand what each of the 52 plans offers," Dawal said. "By the time you have it figured out, it would be time to renew. The program figures it out for you."

Don't Miss the Medicare Education Seminars in November

Linda Dawal can help you find the right Medicare Part D drug plan for you at seminars she is presenting the third week in November. Medicare Part D Seminars are scheduled for the following dates and locations:
* Date/Time: Monday, November 16, from 9 to 11 a.m., Newark Senior Center, 7401 Enterprise Drive, Newark.
* Date/Time: Tuesday, November 17, from 10 a.m. to 1 p.m. Location: Conrad E. Anderson, MD Auditorium; 2500 Mowry Avenue (Washington West), Fremont.
* Date/Time: Wednesday, November 18, from 10 a.m. to 12 p.m. and 2 to 4 p.m. Location: Conrad E. Anderson, MD Auditorium; 2500 Mowry Avenue (Washington West), Fremont.
* Date/Time: Thursday, November 19, from 9 to 11 a.m., Location: Ruggieri Senior Center, 33997 Alvarado-Nile Road, Union City.

Dawal will also offer a seminar on Medicare Supplement Plans on Friday, November 20, from 10 a.m. to 1 p.m. at the Conrad E. Anderson, MD Auditorium, 2500 Mowry Avenue (Washington West), Fremont.

Dawal and Kristi Caracappa at Washington Hospital can help you enroll in the Medicare Part D plan of your choice when you make an appointment with one of them.

For questions about health insurance or to schedule an appointment, call (510) 494-7005. To learn more about Washington Hospital, visit

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