Should I enroll in Medicare Part B before Cobra ends?
When your employment ends, Medicare becomes your primary insurance. If you wait to enroll in Part B until after your COBRA ends, you may not be able to get coverage right away and you may have to pay a late enrollment penalty.
How long can you keep Cobra if you have Medicare?
You can keep COBRA coverage for 18 or 36 months, depending on your situation. If you have Medicare, COBRA can be used to supplement your coverage and help pay for more services. In some situations, using COBRA and Medicare together might save you money.
How do Medicare and Cobra work together?
How Medicare and COBRA work together depends on which type of coverage you have first. If you have Medicare first and then become eligible for COBRA, you can have both Medicare and COBRA. It is important to remember that Medicare pays first and COBRA pays second.
When do I have to pay for COBRA continuation coverage?
A group health plan cannot require payment for any period of COBRA continuation coverage earlier than 45 days after the day on which the qualified beneficiary made the initial election for continuation coverage. Q17: Once the first payment is made, when do I have to submit payments for all future COBRA premiums?
Can you have Medicare Part B and COBRA?
If your Medicare benefits (Part A or Part B) become effective on or before the day you elect COBRA coverage, you can continue COBRA coverage as well as having Medicare. This is true even if your Part A benefits begin before you elect COBRA but you don't sign up for Part B until later.
Do I need 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.
When you retire How long do you to transition to COBRA?
Your plan must give you at least 60 days to choose whether or not to elect COBRA coverage, beginning from the date the election notice is provided or the date you would otherwise lose coverage under your group health plan due to the qualifying event, whichever is later.
Can you have Medicare and Cobra insurance 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.
Can you keep COBRA after age 65?
It rarely, rarely, RARELY makes sense if you are sixty-five or older to elect COBRA (the temporary extension of group coverage) even when it is subsidized by the former employer as part of a severance package. If you are on COBRA when you become eligible for Medicare, the COBRA is typically supposed to end.
Is COBRA primary or secondary to Medicare?
COBRA is always secondary to Medicare. This means that it only pays after Medicare pays. If you do not enroll in Medicare when you become eligible for it, it will be as if you have no insurance. If you have Medicare first and then become eligible for COBRA, you can enroll in COBRA.
Does COBRA end when Medicare begins?
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.
Does COBRA have to be offered to retirees?
When you do retire, you will probably have the option of continuing on your employer's health plan for at least 18 months, thanks to a federal law called the Consolidated Omnibus Budget Reconciliation Act (COBRA). It says that when you leave your job, your employer must let you keep your coverage for up to 18 months.
Do I qualify for COBRA if I retire early?
COBRA may be a good option for you Under COBRA, a retired employee can receive the same health insurance coverage for up to 18 months. But you must pay the entire premium - part of which your employer probably previously covered.
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.
Is Medicare entitlement A COBRA qualifying event?
Medicare entitlement of the employee is listed as a COBRA qualifying event; however, it is rarely a qualifying event. In situations where it is a qualifying event, it is only a qualifying event for the spouse or children that are covered under the group health plan.
How long does a retiree have to have Cobra?
When retirees are covered under a separate group health plan or under the same plan as active employees but with different terms, however, employers must offer at least 18 months of COBRA coverage at the same time they offer retiree medical coverage.
What is Cobra insurance?
0 comment (s) For private-sector employers who offer group health insurance plans and have 20 or more employees, the Consolidated Omnibus Budget Reconciliation Act (COBRA) requires that continuing medical care benefits be made available to former employees who lose their coverage due to a “qualifying event.”.
What is a termination of Cobra?
Under COBRA rules, “employment termination” is a triggering event if it results in loss of coverage for a covered employee, spouse or dependent children. While the termination can be involuntary (“for cause”) or voluntary (retirement, for example), being fired for gross misconduct disqualifies former employees.
How long does a spouse have to be on a disability to continue coverage?
If a retiree’s spouse or children lose coverage due to a qualifying event (death of the retiree, divorce or a child’s ceasing to be a dependent), employers must give them the opportunity to elect continued coverage, with a maximum coverage period of 36 months from the date of the qualifying event.
How long is the grace period for COBRA?
COBRA Fines and Penalties. The IRS is authorized to assess an excise tax penalty for an employer’s failure to follow COBRA guidelines after a 30-day grace period to correct a negligent or accidental violation.
Is COBRA a qualifying event for active employees?
So it is rarely a COBRA qualifying event for active employees. But, Medicare statutory rules allow employer-sponsored group health plans to reduce or terminate coverage if retired employees become entitled to Medicare due to age. If employers take such action and it leads to a loss of coverage for retirees’ spouses or dependents under the terms ...
Can covered employees be eligible for Medicare?
Covered employees are entitled to Medicare when they are both eligible and enrolled in the Medicare program. “Medicare entitlement” – which can be a COBRA triggering event – rarely causes a loss of plan coverage for active employees, because Medicare Secondary Payer provisions of the Social Security Act prohibit terminating group health plans ...
How does Medicare work with my job-based health insurance when I stop working?
Once you stop working, Medicare will pay first and any retiree coverage or supplemental coverage that works with Medicare will pay second.
When & how do I sign up for Medicare?
You can sign up anytime while you (or your spouse) are still working and you have health insurance through that employer. You also have 8 months after you (or your spouse) stop working to sign up.
Do I need to get Medicare drug coverage (Part D)?
Prescription drug coverage that provides the same value to Medicare Part D. It could include drug coverage from a current or former employer or union, TRICARE, Indian Health Service, VA, or individual health insurance coverage.
Do you pay Medicare Part A premiums?
Medicare is divided into parts. Medicare Part A is hospital coverage, and most people do not pay a premium for it. As long as you’re eligible for Social Security or Railroad Retirement Board benefits, you won’t pay Part A premiums.
Does Medicare Advantage cover Cobra?
The cost of Medicare Advantage plans varies depending on the plan you choose and your location. Not all plans are available in all states. You can generally find Medicare Advantage plans that cover services original Medicare doesn’t. Your costs compared to a COBRA plan will depend on the details of the COBRA plans and Advantage plans available to you.
Does Cobra save money?
A COBRA plan is likely to cover services that original Medicare doesn’t. Depending on your need for those services, COBRA might save you money. But purchasing a supplemental Medigap plan can also help cover some of those costs and may be less expensive than COBRA. It’s important to read your plan details carefully and compare it with Medicare coverage.
Does Cobra include Medicare?
Your COBRA plan will likely include coverage for medications but you’ll be responsible for paying the entire premium amount. Medicare Part D plans are available at a wide variety of premiums. You can choose a plan that fits your needs and budget.
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).
How long do you have to notify a disability plan of a disability determination?
If the plan does not specify an alternative 60-day period with respect to a disability determination issued before the qualifying event, the qualified beneficiary is required to notify the plan of the disability determination only within the initial 18-month period of continuation coverage.
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.
How long is Cobra coverage?
In certain circumstances, if a disabled individual and non-disabled family members are qualified beneficiaries, they are eligible for up to an 11-month extension of COBRA continuation coverage, for a total of 29 months. The criteria for this 11-month disability extension is a complex area of COBRA law. We provide general information below, but if you have any questions regarding your disability and public sector COBRA, we encourage you to email us at [email protected].
How long does it take to get a Cobra notice?
Separate requirements apply to the employer and the group health plan administrator. An employer that is subject to COBRA requirements is required to notify its group health plan administrator within 30 days after an employee’s employment is terminated, or employment hours are reduced. Within 14 days of that notification, the plan administrator is required to notify the individual of his or her COBRA rights. If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.
What is a Cobra notice?
A notice of COBRA rights generally includes the following information: A written explanation of the procedures for electing COBRA, The date by which the election must be made, How to notify the plan administrator of the election, The date COBRA coverage will begin, The maximum period of continuation coverage, The monthly premium amount,
How long do you have to notify Cobra?
Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage.
What is the COBRA requirement?
Title XXII of the Public Health Service (PHS) Act, 42 U.S.C. §§ 300bb-1 through 300bb-8, applies COBRA requirements to group health plans that are sponsored by state or local government employers. It is sometimes referred to as “public sector” COBRA to distinguish it from the ERISA and Internal Revenue Code requirements ...
What is a Cobra election notice?
The COBRA election notice should contain the address to which premium payments should be sent and should be provided by the employer or group health plan administrator along with the amount of the premium due and its due date.
How long does an employer have to issue a Cobra election notice?
If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.
How long does Medicare Part B last?
When they retire, accept a buyout or are laid off, they then get an eight-month special enrollment period to sign up for Medicare Part B (which covers doctors visits and other outpatient services) immediately and without penalty. But many people in these circumstances are able to extend their employer coverage for a year or two under ...
How long can you have continuous coverage with Cobra?
He may be able to get coverage under another law that allows people who have had continuous coverage from an employer plan and COBRA for at least 18 months to buy insurance regardless of preexisting conditions, but this is usually very expensive.
How long can you sign up for Cobra without penalty?
The confusion is compounded by the fact that Medicare Part D, the prescription drug benefit, has a different rule: People whose COBRA benefits expire are allowed a two-month special enrollment to sign up with a drug plan without penalty.
How long did Bill Bregar go without health insurance?
He was wrong. They were told they wouldn’t be able to get Medicare coverage until July 2010. Suddenly, in their late 60s, they faced the prospect of 13 months without health insurance. “My reaction was disbelief,” he recalls. “My wife went into shock.”
Is Medicare a month late?
No Medicare for months. Many older Americans who fall into the Part B-COBRA trap aren’t so concerned about the late penalty, but say the prospect of no insurance for months is frightening. Like most others, Fine’s insurance options after COBRA ends are limited.
Is Harvey Fine covered by Cobra?
But last summer he was laid off and now he and his wife, Lucille, are covered under COBRA until December. He, too, was stunned to discover last month that they’d fallen into the unforeseen trap and would have to wait until next July for Medicare. Everyone had told him that COBRA was simply an extension of his employer’s group coverage —“same policy, same card, same everything,” he says. “The hidden point to me was this eight-month window. You lose out unless you know these things.”
Is there confusion about Medicare and Cobra?
“It’s clear from the number and types of calls we get on our hotlines that there is a lot of confusion about how Medicare works with COBRA,” says Joe Baker, president of the Medicare Rights Center. “Not only are individuals confused, but employers are as well, and the price of the confusion can be devastating for some.”
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 ...
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 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, ...
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.
Does John have a SEP?
If he had taken action during that time, there would have been no penalty or delay in coverage. Now, because John is no longer employed, he does not qualify for a SEP and, as a result, he faces a delay in coverage and a Part B penalty.
Table of Contents
Background
Premium Assistance
- In General.Despite the fact that COBRA and State "mini-COBRA" laws may make continuation coverage available to employees who lose their jobs, as well as their dependents (qualified beneficiaries), many unemployed individuals and family members cannot afford the cost of the continuation coverage. These individuals may qualify for a subsidy under the American Recover…
Covered Benefits
- Federal COBRA requirements only apply to employment-related group health plan coverage. They do not apply to individual or association health insurance policies, and they do not apply to any non-health benefits through the employer, such as life insurance. Qualified beneficiaries are generally entitled to continue the same coverage they had immediately before the qualifying eve…
Periods of Coverage
- 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. If a qualified beneficiary is determined to be entitled to disability benefits under Titles II or XVI of the Soc...
Shortened Periods of Coverage
- Continuation coverage generally begins on the date of the qualifying event and ends at the end of the maximum period. However, a period of coverage may end earlier if: 1. an individual does not pay premiums on a timely basis. 2. the employer ceases to maintain any group health plan. 3. after the COBRA election, an individual obtains coverage with another employer group health pla…
Notices Required of Qualified Beneficiaries
- An employee or qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce (or legal separation if that results in loss of plan coverage) or a child's ceasing to be covered as a dependent under the plan's rules. Also, a qualified beneficiary must notify the plan administrator within 60 days of those events when they occur during the initial 1…
Paying For Coverage
- Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. COBRA coverage may be less expensive, though, than individual health coverage. Premiums for COBRA continuation cove…
Other Coverage Considerations
- In deciding whether to elect COBRA continuation coverage, you should consider all your health care options. 1. For instance, one option that may be available is "special enrollment" in a group health plan sponsored by a spouse's employer, if enrollment is requested within 30 days of loss of your health coverage. (If you decide to elect COBRA coverage under your plan, special enrollmen…
Contact Information
- If you are unable to find the COBRA-related information you are looking for on this Website, you may e-mail us at [email protected]. Below are other sources of information about continuation coverage benefits, and subsidies and other rights under ARRA. 1. Centers for Medicare & Medicaid Services (CMS). For assistance with questions regarding premium assistance for conti…