What happens if I turn 65 while on COBRA?
The risks in electing COBRA at 65 or older include missing Medicare Part B enrollment deadlines and paying premium penalties, having a gap in medical coverage and being responsible for large medical bills you didn't anticipate.
How does COBRA interact with Medicare?
If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up. You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA. If you miss this period, you'll have to wait until January 1 - March 31 to sign up, and your coverage will start July 1.
Can I stay on COBRA after age 65?
You may be on COBRA after your employment ends, but once you are eligible for Medicare, you should enroll in Medicare A & B. This enrollment in Medicare would usually mean that you drop the COBRA coverage that you had.
Can you have COBRA and Medicare Advantage at the same time?
If you become eligible and enroll in Medicare before COBRA, the good news is that you can have both. Taking COBRA is optional, and depending on your situation, you may or may not want to. If you do decide to take COBRA, do not drop your Medicare plan.
Do I have to enroll in Medicare Part B if I have COBRA?
If you have COBRA when you become Medicare-eligible, your COBRA coverage usually ends on the date you get Medicare. You should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends.
Can my spouse go on COBRA If I go on Medicare?
But if your spouse became eligible for Medicare and then left his or her employment (and thus lost access to employer-sponsored coverage) within 18 months of becoming eligible for Medicare, you can continue your spousal coverage with COBRA for up to 36 months from the date your spouse became eligible for COBRA.
How long can a retiree stay on COBRA?
18 MonthsRetirees may use COBRA Insurance For 18 Months When a qualified beneficiary retires from their job, the retired worker is entitled for up to 18 months health insurance continuation, which is the maximum amount of time an employee can keep COBRA continuation.
When can COBRA be extended to 36 months?
When the qualifying event is the end of employment or reduction of the employee's hours, and the employee became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the employee's spouse and dependents can last until 36 months after the date the employee becomes entitled to Medicare ...
How long can you stay on COBRA?
Employees are eligible for 18 months of continued coverage under COBRA if the qualifying event stems from reduction of hours or termination of employment for reasons other than gross misconduct. Note that termination can be voluntary or involuntary, including retirement.
Does Medicare recognize COBRA as creditable coverage?
Does COBRA Count as Creditable Coverage for Medicare? To avoid penalties with Medicare, you must have creditable coverage. This means coverage that's at least equivalent to Medicare. COBRA does NOT meet these standards.
Is COBRA more expensive than Medicare?
For most people, COBRA will be significantly more expensive than Medicare.
Why is COBRA not creditable coverage?
COBRA is not normally considered to be creditable coverage for Medicare major medical benefits, so people who are enrolled in COBRA and do not enroll in Medicare Part B within 8 months of turning 65 face substantial financial penalties for the rest of their lives, even if they have months or years left on their COBRA ...
How long does Cobra last?
COBRA coverage generally is offered for 18 months (36 months in some cases). Ask the employer's benefits administrator or group health plan about your COBRA rights if you find out your coverage has ended and you don't get a notice, or if you get divorced.
How many employees can you have with Cobra?
In general, COBRA only applies to employers with 20 or more employees. However, some states require insurers covering employers with fewer than 20 employees to let you keep your coverage for a limited time.
What is a Part B late enrollment penalty?
In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families. This is called "continuation coverage.".
How long do you have to sign up for Part B?
If you’re eligible for Medicare, you don’t qualify for COBRA coverage without having to pay a premium. You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA.
What is the number to call for Medicare?
If your group health plan coverage was from a state or local government employer, call the Centers for Medicare & Medicaid Services (CMS) at 1-877-267-2323 extension 61565. If your coverage was with the federal government, visit the Office of Personnel Management.
Do you have to tell Cobra if you are divorced?
You or the covered employee needs to tell the plan administrator if you qualify for COBRA because you got divorced or legally separated (court-issued separation decree) from the covered employee, or you were a dependent child or dependent adult child who's no longer a dependent.
Do you have to tell your employer if you qualify for Cobra?
Once the plan administrator is notified, the plan must let you know you have the right to choose COBRA coverage.
What happens if you enroll in Cobra?
This means that if your employees enroll in COBRA instead of Medicare, once COBRA coverage ends, they will have to wait until the next annual enrollment period to enroll in Medicare, and they will have to pay late penalties. The late penalties are not minor, either. For Medicare Part B, for example, the monthly premium goes up 10 percent ...
What is the cobra law?
The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is a federal law that requires employers to offer health care continuation to covered employees, their spouses and their dependents after a qualifying event. Enrollees can be required to pay 102 percent of premium costs, which includes the full premium and a 2 percent administrative fee.
How much does Medicare Part B premium go up?
For Medicare Part B, for example, the monthly premium goes up 10 percent for every 12-month period enrollment was delayed. Enrollees have to pay this penalty for the rest of their lives. If your employees are trying to decide between COBRA and Medicare, make sure they understand that they must enroll in Medicare if they want to avoid expensive ...
How to contact CMS about Medicare?
Your employees can contact the CMS Benefits Coordination & Recovery Center at 1-855-798-2627 with questions about Medicare and COBRA. As always, do your best!
Is Medicare Part A free?
Some younger individuals with certain chronic health conditions may qualify as well. Some of your employees may be disappointed to learn that Medicare is not free, although most enrollees qualify for premium-free Medicare Part A.
Is Medicare a qualifying event?
Yes. Employee enrollment in Medicare is considered a qualifying event under COBRA. Imagine this scenario: One of your employees turns 65 and ages into Medicare, but he’s not ready to retire yet. He keeps working. Now he has two health plan options: his group health plan and Medicare.
Is Cobra the same as Medicare?
If someone is enrolled in both COBRA and Medicare, Medicare is the primary insurance. In other words, Medicare pays first, and COBRA may pay some of the costs not covered by Medicare. Certain benefits are not included in traditional Medicare. For example, dental, vision and hearing benefits are generally excluded from Medicare coverage, ...
When is COBRA primary?
Note: If you are eligible for Medicare due to End-Stage Renal Disease (ESRD), your COBRA coverage is primary during the 30-month coordination period. Be sure to learn about ESRD Medicare rules when making coverage decisions.
Is Medicare Part A or Part B?
If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA. Medicare is your primary insurance, and COBRA is secondary. You should keep Medicare because it is responsible for paying the majority of your health care costs.
What happens if you keep Cobra?
Finally, if you keep COBRA while eligible but not enrolled in Medicare, your ex-employer's insurance plan may refuse to pay for the part of a medical bill that Medicare would have paid if you were enrolled. Normally Medicare covers 80 percent, and the COBRA insurance may cover only 20 percent, meaning 80 percent of the cost could be on ...
How long does Cobra last?
The Consolidated Omnibus Budget Reconciliation Act (COBRA) lets people who have left jobs keep employer-provided health coverage for 18 to 36 months provided they pay up to the employer's full cost plus 2%.
Is it normal to have Medicare and Cobra?
Normally Medicare covers 80 percent, and the COBRA insurance may cover only 20 percent, meaning 80 percent of the cost could be on the consumer, Toumayants warns. This won't happen if you enroll in Medicare. "It's perfectly normal for somebody to have Medicare and COBRA," Toumayants explains. "Medicare would be the primary insurance ...
Can Medicare Supplemental Insurance be added to Cobra?
Medicare supplemental insurance to pay for the 20% that Medicare would not cover can be added for a fraction of the cost of COBRA coverage, Toumayants says. "I've never seen a situation where somebody who's eligible for Medicare would be better off keeping Medicare and COBRA," he says.
Does Medicare charge late enrollment penalties?
Medicare charges people late enrollment penalties for not signing up when eligible. The fees permanently raise the monthly Medicare Part B premium, Toumayants explains. If you are still employed when you turn 65, there won't be any late fee.
Do you have to sign up for Cobra after turning 65?
However, if you are no longer covered by an employer-sponsored health plan for any reason, including leaving your job, you need to sign up soon after turning 65 to avoid late fees. Some over-65s covered by COBRA from an ex-employer may reason that they are covered by an employer plan.
Is it safe to keep Cobra?
It's Dangerous to Keep COBRA When You're Eligible for Medicare. It may seem easier to keep a former employer's health plan coverage if you leave your job after age 65, but it's probably best to sign up for Medicare. Author:
What is Cobra coverage?
This section provides information about COBRA continuation coverage requirements that apply to state and local government employers that maintain group health plan coverage for their employees. Group health plan coverage for state and local government employees is sometimes referred to as “public sector” COBRA to distinguish it from the requirements that apply to private employers. The landmark COBRA continuation coverage provisions became law in 1986. The law amended the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code and the Public Health Service Act (PHS Act) to provide continuation of employer-sponsored group health plan coverage that is terminated for specified reasons. CMS has jurisdiction to interpret and administer the COBRA law as it applies to state and local government (public sector) employers and their group health plans. Individuals who believe their COBRA rights are being violated have a private right of action. The COBRA law only applies to group health plans maintained by employers with 20 or more employees in the prior year. In addition, the law does not apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations, or the federal government. (The Federal Employees Health Benefit Program is subject to generally similar requirements to provide temporary continuation of coverage (TCC) under the Federal Employees Health Benefits Amendments Act of 1988.)
How long does Cobra last?
In most cases, COBRA coverage for the covered employee lasts a maximum of 18 months. However, the following exceptions apply: 29-Month Period (Disability Extension): Special rules apply for certain disabled individuals and family members.
What happens after a COBRA election?
the employer ceases to maintain any group health plan. after the COBRA election, an individual obtains coverage with another employer group health plan. after the COBRA election, a beneficiary first becomes entitled to Medicare benefits.
How long does it take for a group health plan to notify the administrator of a second qualifying event?
If a second qualifying event is the death of the covered employee or the covered employee becoming entitled to Medicare benefits, a group health plan may require qualified beneficiaries to notify the plan administrator within 60 days of those events, as well.
How long do you have to notify Medicare plan administrators of a qualifying event?
Employers must notify plan administrators of a qualifying event within 30 days after an employee's death, termination, reduced hours of employment, or entitlement to Medicare (when an employee's Medicare entitlement results in loss of plan coverage for the employee's dependents).
What are the second qualifying events for Medicare?
Second qualifying events may include the death of the covered employee, divorce or legal separation from the covered employee, the covered employee becoming entitled to Medicare benefits (under Part A, Part B or both), or a dependent child ceasing to be eligible for coverage as a dependent under the group health plan.
What happens if you don't pay your insurance premiums?
If you do not make premium payments by the first day of the period of coverage, the plan has the option to cancel coverage until payment is received and then reinstate the coverage retroactively to the beginning of the period of coverage if payment is made within the grace period.
What happens if you fail to pay Cobra premiums?
Late payments (or failure to pay COBRA premiums) may result in a loss of coverage. You are at the mercy of the plan sponsor.
How long is Cobra coverage?
Federal COBRA is available for a minimum of 18 months following a qualifying event and may be available up to 36 months for certain circumstances (or under State COBRA rules). Make sure you understand when you have exhausted your COBRA coverage benefits and need to seek out alternative coverages.
What is Cobra insurance?
COBRA is commonly used to provide continuous group health coverage between employment. You got the new job! The benefits are awesome. The only problem, you have a waiting period before you are eligible to enroll. So you enroll in COBRA to avoid a gap in coverage. Your benefits finally kick-in and you no longer need COBRA. You will need to notify the plan sponsor (or designated COBRA administrator) to terminate your COBRA coverage. Be sure to specify the date your new group coverage begins and COBRA coverage ends. Any overpayment of premiums is returned to you.
When does Cobra end?
If you already have COBRA when you enroll in Medicare, your COBRA coverage usually ends on the date you enroll in Medicare. If you have COBRA and become Medicare-eligible, you should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends. Your spouse and dependents may keep COBRA for up to 36 months if certain conditions are met, regardless of whether you enroll in Medicare during that time.
What happens if a group plan no longer exists?
If a group plan no longer exists for any active employees, there is no longer an opportunity for you to maintain coverage through COBRA. This is where it gets a little dicey. Through no fault of your own, your COBRA coverage may be terminated early.
How to ensure continuous uninterrupted coverage?
To ensure continuous, uninterrupted coverage, always pay your premiums by the due date. When you enrolled in COBRA, you likely received a coupon book to easily track payment amounts and due dates. Note on starting alternative coverages.
Why does my employer stop providing insurance?
The decision to stop providing coverage may be the result of a company closure, bankruptcy filing or just an evaluation of benefits offered.
What happens to a qualified beneficiary after electing Cobra?
The qualified beneficiary becomes covered by another group health plan after electing COBRA. The qualified beneficiary becomes entitled to Medicare after electing COBRA . A qualified beneficiary who had been disabled is determined not to be disabled.
How long can you extend Cobra?
The Medicare entitlement of the individual can extend COBRA for the individual’s spouse and dependents for up to an additional 18 months (36 months in total) if the COBRA-qualifying event (termination of employment or a reduction of hours of the employee) occurs within 18 months after the individual became entitled to Medicare. Note, this would not apply to the normal 36-month periods that the spouse or dependent would have based on the death of the employee, divorce or the dependent losing eligibility.
What is Medicare eligibility?
The COBRA regulations repeat the definition of the Medicare regulations. The Medicare regulations state eligibility for Medicare is the time when an individual meets all the requirements for entitlement to Medicare except application or enrollment in Medicare. Entitlement to Medicare, therefore, means all the requirements for Medicare have been ...
How long does it take for a cobra to be extended?
If the employee enrolled in Medicare 17 months before the COBRA-qualifying event, there could be up to an additional 19 months of COBRA. Again, Medicare eligibility is not enough to extend COBRA under the rules, so employers need to be aware of the actual enrollment in Medicare and not use an employee’s age as a proxy.
How long does it take for a covered employee to get Medicare?
A divorce or legal separation from the covered employee – 36 months. Ceasing to be a dependent child under the terms of the plan – 36 months. The covered employee becomes entitled to Medicare – 36 months.
When does a qualified beneficiary become eligible for Medicare?
The regulation states, “ [A] qualified beneficiary becomes entitled to Medicare benefits upon the effective date of enrollment in either part A or B, whichever occurs earlier. Thus, merely being eligible to enroll in Medicare does not constitute being entitled to Medicare benefits.”.
Can you enroll in Medicare if you are not employed?
In addition, there are insurance policies that assume the people who are not actively employed are enrolled in Medicare for purposes of coordination of benefits policies, which would be relatively rare for COBRA participants, as those policies would more often end upon enrollment in Medicare.
How old is John from Medicare?
John, 68 years old, lost his position in September 2017. He enrolled in Medicare Part A and COBRA. He was told he didn’t need Part B because the COBRA plan provides the same coverage he had for years. Now, because the coverage will end in February, he has re-started the Medicare enrollment process. To his surprise, he discovered ...
Can you get bit by a cobra?
Don't get bit by your COBRA. Getty. Being on COBRA after age 65 is like hiking in the woods. It's great until a snake jumps out and bites you.
What is the law for cobra?
The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations. In addition, many states have laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA). Check with your state insurance commissioner's office to see if such coverage is available to you.
How long can a spouse continue Cobra?
A covered employee's spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice, generally within 14 days, to the qualified beneficiary of the right to elect COBRA continuation coverage.
What is FMLA coverage?
The Family and Medical Leave Act (FMLA) requires an employer to maintain coverage under any group health plan for an employee on FMLA leave under the same conditions coverage would have been provided if the employee had continued working. Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA. A COBRA qualifying event may occur, however, when an employer's obligation to maintain health benefits under FMLA ceases, such as when an employee taking FMLA leave decides not to return to work and notifies an employer of his or her intent not to return to work. Further information on the FMLA is available on the Website of the U. S. Department of Labor's Wage and Hour Division at dol.gov/whd or by calling toll-free 1-866-487-9243.
What is continuation coverage?
If you elect continuation coverage, the coverage you are given must be identical to the coverage currently available under the plan to similarly situated active employees and their families (generally, this is the same coverage that you had immediately before the qualifying event). You will also be entitled, while receiving continuation coverage, to the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during open enrollment season to choose among available coverage options. You will also be subject to the same rules and limits that would apply to a similarly situated participant or beneficiary, such as co-payment requirements, deductibles, and coverage limits. The plan's rules for filing benefit claims and appealing any claims denials also apply.
How long do you have to elect Cobra?
If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.
Can you use the Health Coverage Tax Credit for Cobra?
The Health Coverage Tax Credit (HCTC), while available, may be used to pay for specified types of health insurance coverage ( including COBRA continuation coverage).
Can you extend your 18 month coverage?
If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.
