Tuesday, January 27, 2009

3. Look into private health insurance.

You can buy your own health insurance in the private health insurance market. Zirkelbach advises shopping around and taking a careful look at what you're buying, including:

  • Co-payments: a dollar amount you're expected to pay for doctor visits or prescriptions
  • Co-insurance: a percentage of medical bills that you're responsible for
  • In-network and out-of-network doctors: If you have a specific doctor in mind, ask the doctor's office or the health insurance company if that doctor is in the company's network of physicians.
  • Formularies: Find out if your medications are covered and what you would pay for them.

2. Consider COBRA.

COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1986) allows you to keep the health insurance you had through your employer for up to 18 months.

COBRA will cost more than what got taken out of your former paycheck. Besides paying what you paid as an employee, you'll also pick up the tab that your employer covered, and you may also pay a 2% administrative fee.

"That can be cost prohibitive, but that is an option for people; they are able to keep that coverage during the time of transition," says Robert Zirkelbach, director of strategic communications for America's Health Insurance Plans, a trade group for health insurance companies.

Still, the U.S. Department of Labor's web site notes that "while COBRA rates may seem high, you will be paying group premium rates, which are usually lower than individual rates."

If your company closed or went bankrupt, COBRA won't be available; it's only an option if your company's health care plan is still around. And you have to enroll in COBRA; companies with at least 20 employees are usually required to offer COBRA coverage and to let employees know about that, according to the Department of Labor.

1. Check with your spouse or partner.

If you're married or have a partner who has health insurance through their employer, look into getting added to their plan via special enrollment. That's often the most cost-effective option, and you don't have to wait until the open enrollment period -- but you need to do it within 30 days of losing eligibility for other coverage, according to background information posted on the Department of Labor's web site.

Laid Off? 10 Health Care Tips From COBRA to Private Health Insurance to Coping With Stress, Here's What to Do

Dec. 15, 2008 -- With the markets roiling and the ranks of the unemployed growing, it's time to take a cold, hard look at a worker's worst-case scenario: being laid off.

If it happens to you, and you had health insurance through your employer, what are your options now? And what about the toll that losing your job can take on your physical and mental health?

Here are 10 practical tips about health insurance and health care, in case the pink slip comes.

Is freezing bottled water or leaving it in a hot car dangerous?

Both of these concerns have circulated widely in emails and on the Internet. One email that has been around for several years warns that freezing bottled water leads to contamination with carcinogenic dioxins.

The email was erroneously attributed to Johns Hopkins University, and it was so widespread that Johns Hopkins' scientists felt compelled to publicly set the record straight in a news release.

Rolf Halden, PhD, PE, who is an adjunct associate professor with the Johns Hopkins Center for Water and Health, called the claim "urban legend."

He notes that there are no dioxins in plastics and that freezing actually slows or prevents the release of chemicals.

The industry group representing single-use beverage bottle manufacturers, known as NAPCOR also used the term "urban legend" to describe claims that it is unsafe to drink water that has been left in a hot car.

"The idea that (these) bottles 'leach' chemicals when heated in hot cars is not based on any science, and is unsubstantiated by any credible evidence," the group noted in a recent news release. "This allegation has been perpetuated by emails until it has become an urban legend, but it just isn't so."

Is there fluoride in bottled water?

If it is added by the bottler, the label must say so. But most bottled waters probably don't have as much fluoride as fluoridated tap water.

The CDC has stated that most bottled waters contain fluoride at levels that are less than optimal for oral health. It weighed in on the issue in a news release last February.

"If you mainly drink bottled water with no or low fluoride and you are not getting enough fluoride from other sources, you may get more cavities than you would if fluoridated tap water were your main water source," the statement noted.

The CDC also warns that preparing infant formula with fluoridated bottled water could cause dental fluorosis, a condition in which permanent white spots occur on the teeth.

Can chemicals leach from plastic bottles and pose a health risk?

Most experts who spoke to WebMD say there is little to worry about.

The major concerns have involved the chemicals bisphenol A and phthalates.

Bisphenol A is used in the production of multiuse polycarbonate water bottles, but not in single-use bottles used by commercial bottlers.

Likewise, phthalates are not typically found in plastic beverage bottles used commercially in the U.S. But Janssen says phthalates have been found in bottled water, suggesting that it may leach from the plastic cap or liner.

"These chemicals may be in your water, but you would never know because the water companies are not required to test for them," she says.

Is it safe to drink old bottled water?

The FDA considers bottled water to have an "indefinite safety shelf life" if it is unopened and properly sealed, but drinking water quality expert Rolf Halden, PhD, of Arizona State University is not so sure.

"Even water stored for emergency use should be replaced periodically," he tells WebMD. "You wouldn't want to keep it for 10 years."

If I drink tap water, should I use a filter?

f you live in a home with older pipes, have odor or taste issues with your tap water, or just want an extra level of protection, a filter may be a good idea. But you have to get the right one for your specific problem, Janssen says.

"It is important to know what you are trying to filter out before you spend the money," she says. "A reverse osmosis filter will get rid of most contaminants, but charcoal may be enough for odor and taste problems."

The Natural Resources Defense Council web site is a good source for information on filters.

The consumer watchdog group Consumers Union, publisher of Consumer Reports, also weighed in on commercial filters in a report published early last year.

To find out which filter is best for you, the report recommended consulting the Consumer Confidence Report (CCR), published online each July by the EPA.

The report provides detailed information about where your tap water comes from along with detected levels of dozens of regulated contaminants and the corresponding state and federal limits for these contaminants.

To determine the quality of the water actually coming from your faucet, you will have to have it tested. The EPA's Safe Drinking Water Hotline (800-426-4791) can provide the names of state-certified testing labs in your area. Or you can do it yourself for under $20 with a commercially available kit sold at most hardware stores.

Which is safer, bottled or tap water?

Assuming that both the municipal tap water source and the bottler are in compliance with regulations, the experts contacted by WebMD say bottled water is no safer than tap water and tap is no safer than bottled.

The experts point to two cases where bottled water may be recommended -- in emergency situations when contaminants in the local water supply exceed permitted standards and in homes where corroded plumbing could cause lead or copper to contaminate drinking water.

In the first instance, water suppliers are required to notify the community and they may even provide bottled water until the problem has been solved. Homeowners worried about their pipes can have their drinking water tested. Halden says most people choose bottled water for convenience, not safety.

"We have invested in the infrastructure to provide pure, safe, drinking water to the population," he says. "In large cities, water quality is tested hourly, not just once a day."

While that may be true, a recent report by the Associated Press raised new concerns about the purity of tap water.

Its five-month investigation found evidence of a wide range of prescription and over-the-counter drugs -- including antidepressants, antibiotics, anticonvulsants, and sex hormones -- in tested samples of municipal water taken from taps throughout the country.

Twenty-four of the 28 water samples taken from major metropolitan area water supplies contained evidence of drug contamination.

The concentrations of these pharmaceuticals were very small. But the report noted that the EPA has not set safety limits for drugs in water and does not require testing for them.

Does calling the 800 number really get you the information you want?

That depends on what you want to know.

WebMD called the 800 numbers found on three best-selling water brands, purchased at a minimart in Nashville, Tenn. In each case, we were able to find out the source of the water and the purification process used by the bottler.

But in all three cases we were told that there were no contaminants in the water we were calling about because of the extra purification. While this may be true, water quality experts say it is unlikely that the purification process removes all contaminants. And the Environmental Working Group investigation showed that some of the bottled waters they tested had the same type and level of contaminants as the tap water source used by the bottler.

The brands we checked included Pepsi's Aquafina, Coca-Cola's Dasani, and Deer Park Spring Water, marketed by Nestle.

When we called the Pepsi number, a customer service agent helped us find the date stamp and production code on the bottle of Aquafina we had purchased.

With this information, she was able to tell us that our water came from a municipal source in Mankato, Minn. She further informed us that the bottler used a seven-step purification process that included reverse osmosis, carbon, and UV light filtration.

When we called the Coca-Cola number, a customer service agent was able to tell us that our Dasani came from a municipal source in Birmingham, Ala., and that the purification process included reverse osmosis filtration.

Our Deer Park call was answered by a customer service agent who told us where our spring water was bottled and how it was purified.

Sarah Janssen, PhD, who is a scientist with NRDC, says the 800 numbers may help you figure out where the water you purchase comes from but not what is in it.

"I can't imagine that anyone standing in a store trying to make a decision about which water to buy is really going to go to all that trouble," she says.