If you lose your health insurance, or if you are buying health insurance for the first time, don’t panic. This article will discuss your options in New York for obtaining a plan for yourself or your family.
(If you live in New Jersey or Connecticut, visit those states on the Actors Fund’s health insurance resource Web site, at www.ahirc.org.)
We will also look at ways of getting health care if you are unable to afford any of the options listed.
First, if you recently had insurance and you’ve just lost it, remember that you may be able to continue the same insurance for a period of time by paying for it out of your own pocket. This is called COBRA. There are even some state and federal subsidies, so that your COBRA payments may be reduced or even free. Allegro featured a comprehensive story about COBRA in the February issue.
In New York, an insurer must sell you health insurance and cannot ask you about your medical history. In addition, everyone in the same county pays the same amount for the same insurance plan – age and gender are irrelevant. The cost, however, is prohibitive. An HMO plan with Empire Blue Cross is currently $1,169 for an individual and $3,009 for a family – and that’s the monthly bill.
There are two sets of alternatives available: association plans and government-subsidized programs.
The Freelancers Union (www.FreelancersUnion.org) offers three PPO plans and two high-deductible plans to self-employed people who meet their eligibility requirements. (Currently, those requirements are earnings of $10,000 in the past six months or evidence of having worked 20 hours per week for the past eight weeks.)
The PPO plans – which can be used in-network around the country and are therefore especially useful to anyone who travels – range in cost from $285 to $497 a month, depending on the hospital deductible and the co-pays.
The high deductible plans – $324 a month for a $5,000 deductible, and $196 a month for a $10,000 deductible – essentially limit your financial liability for medical care since they kick in at 100 percent once the deductible is reached.
If your income is below $2,257 a month and you can show some work history in the past year you may be eligible for Healthy NY (www.HealthyNY.com). This is government-subsidized insurance through private insurers; monthly premiums range from $280 to $370 for the most comprehensive plan. Although premiums vary, benefits are the same for all plans. There are some limitations and exclusions: there is a $3,000 limit on drug coverage per year and no mental health coverage, for example. You can also purchase plans without drug coverage or with a deductible, which lowers your monthly premium.
New York also offers three other public insurance programs: Family Health Plus, Medicaid, and Child Health Plus, a program for children under age 19.
Medicaid and Family Health Plus have no premiums and low co-pays. Child Health Plus is either free, depending on parental income, or low cost. These are all excellent programs that offer comprehensive coverage. Access NYC (at www.nyc.gov) is a calculator that will evaluate your eligibility for these programs and others, including food stamps.
(Allegro featured a story on Medicaid in its February 2009 issue.)
If you are unable to afford or are ineligible for any of these alternatives, you should apply for HHC Options (also at www.nyc.gov), a program at New York City public hospitals that reduces fees for medical services based on your income. At two of these hospitals, Bellevue and Woodhull, there is a program called Artist Access where artists, including musicians, barter their talents for health care credits. Contact Artists Access at (877) 244-5600.
The Actors Fund Al Hirschfeld Free Health Clinic, at 57th Street and 10th Avenue, is available to uninsured entertainment professionals and performing artists. All primary care services, including lab work, are free, and referrals are made to a network of volunteer specialists who see our patients at no or low cost. Call (212) 489-1939 for an appointment.
New York City also has excellent sliding scale clinics, such as the Ryan Centers and Callen-Lorde in Manhattan. You can find the community clinic nearest to you at FindAHealthCenter.hrsa.gov.
Finally, the Actors Fund offers a one-hour health insurance seminar every Thursday at 12:30 at 729 Seventh Avenue on the 10th floor. You can also call (212) 221-7300, ext. 265 to speak to a health insurance counselor.
Local 802 members may use the union’s Musicians’ Assistance Program as their starting point for any health insurance investigation. Contact Cindy Green at (212) 397-4802 or MAP@Local802afm.org. Cindy can help you with any of the programs discussed in this article or point you in the right direction.
WHAT ABOUT THE LOCAL 802 HEALTH PLAN?
The tips described in the article above are for people searching for health insurance. But Local 802’s goal is that you should qualify for the union’s own health plan. How do you qualify? By playing enough union gigs.
Remember that you can’t buy the union’s health plan out of your own pocket. Local 802’s health plan works like this: every time you play a union job, your employer (such as a Broadway producer, orchestra management, or bandleader) pays a small amount into your health account at Local 802. Once you reach a certain level, you will qualify for the union’s plan for the next six months.
If you teach private lessons, you may be able to have your private students contribute money into your health account. Likewise, you may be able to earn health contributions if you perform private house concerts or give clinics. Ask us about the LS-1 contract. Call Jim Hannen at (212) 245-4802, ext. 141 to learn more.
If you want to know how close you are to qualifying for the union’s health plan, call the Local 802 Health Department at (212) 245-4802. The department can also tell you more about the plan.
Our basic plans do not include hospitalization, but we do offer a buy-in HMO option.
If you aren’t currently playing enough union gigs to qualify for the union’s health plan, our goal is to help you turn your nonunion gigs into union ones. When you get called for nonunion work or if you are teaching or accompanying in a nonunion venue, call Local 802 and give us the chance to make your work union. Every union gig should pay into your health benefits.
There is, of course, a better solution to the problem of health insurance. Local 802 has historically supported the concept of universal health care and that remains part of our political mission. To get involved, contact Paul Molloy at Pmolloy@Local802afm.org or (212) 245-4802, ext. 176