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Author Topic: Summary of Major Health Care Provisions in the Stimulus Package  (Read 1136 times)

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Offline Peter Staley

  • Member
  • Posts: 1,337
  • Founder & Advisory Editor, AIDSmeds.com
    • AIDSmeds.com
Summary of Major Health Care Provisions in the Stimulus Package
« on: February 21, 2009, 12:47:22 PM »
For those with questions about the changes to COBRA and other health care provisions in the new stimulus package (American Recovery And Reinvestment Act of 2009), I found a nice overview here:

http://www.ama-assn.org/ama/pub/legislation-advocacy/current-topics-advocacy/hr1-stimulus-summary.shtml

Offline a2z

  • Member
  • Posts: 186
Re: Summary of Major Health Care Provisions in the Stimulus Package
« Reply #1 on: April 01, 2009, 09:47:22 AM »
Peter, thanks for the link.  Here's the part that leaves me with some concerns and doubts

Subsidy available for up to 9 months.

The words "up to", at least to me, imply more strings attached.

For example, I became unemployed in mid-January with premiums paid for January automatically deducted from my paycheck.  According to the link, I qualify. 

But I became reemployed in February with an employer that has a poor health plan for my HIV needs (my opinion) and at a pay reduction.  Also, I'm not quite sure they have 20 people, so I don't want to jeopardize my COBRA rights anyway.

So there seems to be no guideline as to whether I qualify for the reduced premium for 1 month, the partial month between the time the coverage lapsed and the minute I was reemployed, for 9 months or not  at all.

Has anyone else had luck with this?   Needless to say, my health care broker was not helpful other than to say they still aren't sending out the notices for 7-14 more days (I have 14 days of medicine left, which sorta sucks and is weighing on this decision.)



Dates are blood draw dates:
09/21/09: CD 898 27.0% VL 120 - back on track, same meds.High level enzymes, but less so
06/15/09: CD4 478 21.8% VL 1150 - high liver enzymes... looks like I may not be resistant
05/22/09: Fixed insurance, resumed medicine
04/17/09: Ran out of medicine, could not resolve insurance problems
04/01/09: CD4 773 28% VL 120 - high liver enzymes
12/01/08: CD4 514 23% VL 630
10/17/08 started Reyataz, Norvir and Truvada. -- possibly minor neuropathy, but otherwise okay.
9/10/08: CD4 345 17%, VL > 78K
8/18/08: CD4 312 18%, VL > 60K (considering meds)
12/19/07: CD4 550 28% VL > 100K (no meds yet)
Diagnosed 10/23/07

Offline a2z

  • Member
  • Posts: 186
Re: Summary of Major Health Care Provisions in the Stimulus Package
« Reply #2 on: April 01, 2009, 10:04:11 AM »
I did find one of my answers, but not until after I made the posting

http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionER.html
Dates are blood draw dates:
09/21/09: CD 898 27.0% VL 120 - back on track, same meds.High level enzymes, but less so
06/15/09: CD4 478 21.8% VL 1150 - high liver enzymes... looks like I may not be resistant
05/22/09: Fixed insurance, resumed medicine
04/17/09: Ran out of medicine, could not resolve insurance problems
04/01/09: CD4 773 28% VL 120 - high liver enzymes
12/01/08: CD4 514 23% VL 630
10/17/08 started Reyataz, Norvir and Truvada. -- possibly minor neuropathy, but otherwise okay.
9/10/08: CD4 345 17%, VL > 78K
8/18/08: CD4 312 18%, VL > 60K (considering meds)
12/19/07: CD4 550 28% VL > 100K (no meds yet)
Diagnosed 10/23/07

Offline J.R.E.

  • Member
  • Posts: 7,099
  • Joined Dec-2003 Living positive, since 1985.
Re: Summary of Major Health Care Provisions in the Stimulus Package
« Reply #3 on: April 01, 2009, 07:20:54 PM »


Thanks for the links. I was looking for this information.


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline Assurbanipal

  • Member
  • Posts: 2,173
  • Taking a forums break, still see PM's
Re: Summary of Major Health Care Provisions in the Stimulus Package
« Reply #4 on: April 02, 2009, 06:57:47 AM »
I did find one of my answers, but not until after I made the posting

http://www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionER.html



The Internal Revenue Service issued detailed rules on the stimulus package health care subsidy yesterday. 

http://www.irs.gov/pub/irs-drop/n-09-27.pdf

Generally the Department of Labor is in charge of telling employers what information they must provide to employees while the Internal Revenue Service is in charge of the detailed rules on how the program works.  The Department of Labor material is easier to read but sometimes does not cover finer points, so if you need more information it may be in the Internal Revenue Service rules.


You may find the following Q's and A's helpful to your question

"Q-34. If an assistance eligible individual is eligible for other group health plan
coverage but does not enroll in the other group health plan coverage, is the premium
reduction available for the individual’s COBRA continuation coverage after the date the
individual is first eligible for the other coverage?
A-34. No.
Example 1. An assistance eligible individual begins employment with a new
employer and is eligible to enroll in the employer’s group health plan, with coverage
effective the first day of the next month. The assistance eligible individual declines the
coverage and continues COBRA continuation coverage. Although eligibility for other
group health coverage does not end the individual’s eligibility for Federal COBRA, the premium reduction is no longer available as of the first day of the next month.
Example 2. Same facts as Example 1, except that the new employer’s group
health plan imposes a 2-month waiting period. The premium reduction stops being
available as of the first day after the end of the waiting period, even though the
employee declined coverage under the plan. It is the same result if the employee had
enrolled for coverage; the premium reduction would apply until the first day after the end
of the waiting period.
Example 3. The spouse of an assistance eligible individual (who is also an
assistance eligible individual) begins employment with a new employer and is eligible to
enroll in the employer’s group health plan with self-only or family coverage, with
coverage effective the first day of the next month. The spouse enrolls in self-only
coverage, and the assistance eligible individual continues COBRA continuation
coverage. Although the individual is allowed to continue Federal COBRA, the premium
reduction is no longer available for the COBRA continuation coverage as of the first day
of the next month because the assistance eligible individual is eligible for coverage
under the group health plan of the spouse’s employer.
Q-35. Is an assistance eligible individual who otherwise meets the eligibility
requirements for coverage under a group health plan, but who cannot enroll and have
coverage take effect immediately, considered eligible for coverage under the group
health plan for purposes of ending the period of premium reduction?
A-35. No. An individual who is eligible to enroll for coverage under a group
health plan is considered to be eligible for coverage under the group health plan for
purposes of ending the period of premium reduction only from the first date that
coverage can take effect. For example, if, as of February 17, 2009, an assistance
eligible individual meets the eligibility requirements for coverage under a group health
plan maintained by the individual’s spouse, but cannot enroll and have coverage take
effect immediately, the individual may receive the premium reduction for periods of
coverage until the first date that coverage can take effect under the plan maintained by
the spouse’s employer."
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

 


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