Four alternatives if you lack health insurance

Health insurance broker Mark Withrow hears lots of concerns from those who are unemployed or at work without health insurance.

He understands. Ten years ago he was a job hunter needing an affordable policy. To help others, he has shared with Kansas City, Mo., area job transition support groups a primer on four possible options in advance of expected health reforms:

1. Go without. You'll pay for care only if you need it. That's a big if. If the need is costly, you could wipe out all savings and become bankrupt.

But it's the finger-crossed choice made out of financial necessity or priorities.

2. COBRA coverage. It's expensive and temporary. Available after a job loss, it may be the only coverage offered if health issues prevent getting underwritten for other policies.

You'll probably have to pay the full premium cost, a shocker if you've lost an employer subsidy. But for up to 18 months for COBRA, these could offer needed security.

3. Short-term coverage. Comparatively lower-priced, these "market" policies provide a limited safety net. They won't cover office visit co-payments or prescription drugs, but they give catastrophic coverage.

A typical deductible is $2,500, but there are ranges. Monthly premiums are age-based and range from about $35 to about $130, Withrow said.

A big hitch is that short-term policies won't cover pre-existing conditions, so everyone won't qualify.

4. Individual insurance. This is familiar turf for the self-employed or long-term unemployed who shop around to find policies that fit their needs and pocketbooks.

It, too, can be expensive. And people with pre-existing conditions or other health issues may not qualify or may have to pay an "upcharge" to be underwritten.

"Health insurance is a complicated and confusing topic any time," Withrow said, acknowledging that it's even more stressful when you're unemployed or on a limited budget.

Diane Stafford is the workplace and careers columnist at The Kansas City Star. Her "Your Job" blog at includes daily posts about job-related issues of wide interest.

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