David's workshop took place at The Career Place in Woburn, Massachusetts on October 13, 2009. Feel free to contact me at dpomer99@aol.com.

1. Navigating Health Insurance and Finding Health Care Services
Presenter: David Pomeranz
Major Topics
COBRA: employer required to provide continuity in group coverage, usually for 18 months;
there are exceptions and other cases; www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML
Federal COBRA subsidy: for those who lost / will lose their jobs between Sept. 1, 2008 and
Dec. 31, 2009; 65% subsidy for 9 months; began February 17, 2009; “look back” on COBRA
election but not on premiums; income maximums: $125,000 individual / $250,000 couple
filing jointly. www.dol.gov/ebsa/faqs/faq-cobra-premiumreductionEE.html
State’s COBRA subsidy (Medical Security Program or MSP): Only Massachusetts
residents receiving Massachusetts unemployment benefits are eligible. Income eligibility:
gross household income less than or equal to (<) 400% of the “federal poverty guidelines”
(FPGs). FPG website is at the bottom of this document. For the MSP, income is based on six
months previous and six months projected income. www.mass.gov/dua/msp or 800-908-8801
2006 Massachusetts Health Reform Law: created Massachusetts Health Connector:
www.mahealthconnector.org or 877-623-6765.
• “Individual mandate:” Massachusetts requires individuals to have health insurance or pay
a penalty -- in 2009 – of up to about $1,000. But there is an “Affordability Exemption”
based on a household’s ‘Adjusted Gross Income.’ “Affordability Calculator:”
https://wfb.dor.state.ma.us/dorcommon/tools/hcaffordability/Year2008/Index.aspx
• “Guaranteed issue” -- insurance companies have to waive “pre-existing conditions” unless
there is a break of 63 or more days in health insurance coverage
• “Minimum credible coverage:” for 2009 includes prescription drugs, and caps on
deductibles and out-of-pocket spending. Division of Insurance’s has a list of licensed
health plans: both those which meet the state’s “minimum credible coverage”
requirements, and those that do not (e.g., for those who have “affordability exemptions”)
www.mass.gov/?pageID=ocaterminal&L=5&L0=Home&L1=Consumer&L2=Insurance&L3
=Health+Insurance&L4=Health+Care+Access+Bureau&sid=Eoca&b=terminalcontent&f=d
oi_Consumer_css_health_smlindgroup&csid=Eoca
• Health Plans created by the 2006 Massachusetts Health Reform Law
o Commonwealth Care: state-subsidized health plans for household incomes < 300%
of FPGs; need to complete Medical Benefit Request (MBR): see the end of this
document for information about the MBR; call your doctor(s) to see if they participate
o Commonwealth Choice: commercial health plans for those whose household
incomes are > 300% of the FPGs
MassHealth Essential: unemployed for more than one year
• Household incomes are < to 100% of the FPGs; must be a Massachusetts resident
• need to complete a Medical Benefit Request (MBR)
• www.massresources.org/pages.cfm?contentID=35&pageID=13&subpages=yes&SecondL
eveldynamicID=678&DynamicID=563
• 888-665-9993

2. Health Safety Net / Free Care: not insurance; two types:
1. Protection for those without access to health insurance: e.g., “affordability exemption”
2. People of any income if they have medical bills for which they cannot pay: “Medical
Hardship.” Requires a special application.
• www.massresources.org/pages.cfm?contentID=50&pageID=13&Subpages=yes
• 877-910-2100
• Applications and services only at community health centers and hospitals
o Community Health Centers: www.massleague.org/HealthCenters.htm
o Hospitals: www.mhalink.org/public/mahospitals
“Insurance Partnership” (IP)
• Not insurance: state premium subsidies for self-employed / small businesses
• Household incomes < to 300% of the FPGs
• www.4IP.org or 508-698-2070
Dental and Eye Care
o Tufts Dental School: http://dental.tufts.edu/1202810465883/TUSDM-Page-
dental2w_1245834004492.html or (617) 636-6828
o New England Eye Institute: www.ne-eyeinstitute.org or (617) 262-2020
Dental “Insurance” (example only):-- Delta Dental: www.deltamass.com or 800-451-1249
OTHER RESOURCES:
o HealthNet’s document on “Health Insurance Options For The Unemployed”:
www.compartners.org/news/new-information-resource-unemployed
o Health Care For All
Consumer Health HelpLine: 800-272-4232 or
• www.hcfa.org/index.cfm?fuseaction=Page.viewPage&pageId=523&grandparentID=
496&parentID=767
o Mayor’s Health Line: provides information about all federal and state programs, and
has a “physician finder” service
• 617-534-5050 / 800-847-0710
• www.bphc.org/programs/cib/civicengagement/mhl/accessinghealthinsurance/healthin
surance/Pages/Home.aspx; click on “Health Insurance” hyperlink
OTHER IMPORTANT BACKGROUND INFORMATION TO KNOW
• Federal Poverty Guidelines (FPGs): also known as Federal Poverty Levels
www.mass.gov/Eeohhs2/docs/masshealth/deskguides/fpl_deskguide.pdf
• “Medical Benefit Request” (MBR): this form required for many state programs; for
example, Commonwealth Care; MassHealth Essential; Free Care / Health Safety Net;
www.mass.gov/Eeohhs2/docs/masshealth/appforms/mbr.pdf or 888-665-9993
This is not a comprehensive review of all federal and state programs. I have “vetted” the
information to the best of my ability. Feel free to distribute this document as you see fit.
David can be reached at 617-650-0639 or dpomer99@aol.com. I welcome you to become
one of my connections at www.linkedIin.com/in/dpomer99