Medicare Blog

if my husband turns 65 while we're on cobra from his job what do i do if i'm not medicare eligible

by Zechariah Anderson Published 2 years ago Updated 1 year ago

If you're not yet 65, you may have no choice but to sign up for COBRA and retain your existing coverage, albeit at a hefty cost, or otherwise buy a plan on the health insurance exchange. HOW TO GET HEALTH INSURANCE IF YOU LOSE YOUR JOB

Full Answer

Should you sign up for Cobra or Medicare if you're laid off?

If you're not yet 65, you may have no choice but to sign up for COBRA and retain your existing coverage, albeit at a hefty cost, or otherwise buy a plan on the health insurance exchange. If you're laid-off from a job at age 65 or older, on the other hand, you have more options, because at that point, you can sign up for Medicare.

Do spouses and dependents qualify for Cobra if they have Medicare?

Some people may decide to keep their COBRA coverage along with Medicare in order to retain additional benefits offered through the employer’s health plan. Do spouses and dependents qualify for COBRA if they lose coverage when an employee ages into Medicare? Yes. Employee enrollment in Medicare is considered a qualifying event under COBRA.

Can you be on Cobra after age 65?

Being on COBRA after age 65 is like hiking in the woods. It's great until a snake jumps out and bites you. Just ask any of the five beneficiaries I talked to last week. Here’s a typical situation. John, 68 years old, lost his position in September 2017. He enrolled in Medicare Part A and COBRA.

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.

What happens if I turn 65 while on COBRA?

If you get COBRA Before Medicare If you get COBRA first and then become eligible for Medicare, when you turn 65, COBRA will cease providing primary insurance coverage to you. Medicare will become primary, and if you can keep COBRA, it will become your secondary insurer.

Can my spouse stay on COBRA If I go on Medicare?

Your spouse and dependents may keep COBRA for up to 36 months, regardless of whether you enroll in Medicare during that time. You may be able to keep COBRA coverage for services that Medicare does not cover.

Is Losing COBRA a qualifying event for Medicare?

Although a loss of coverage occurs when employees voluntarily remove themselves from the health plans, the reason (attaining other coverage, including Medicare) is not considered a qualifying event. Therefore, employees are not offered COBRA coverage in this scenario.

How long can a spouse stay on COBRA?

36 monthsIf the qualifying event is the death of the covered employee, divorce or legal separation of the covered employee from the covered employee's spouse, or the covered employee becoming entitled to Medicare, COBRA for the spouse or dependent child lasts for 36 months.

Can I stay on 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.

What happens to my wife when I go on Medicare?

Medicare will only cover you, not your spouse or children if they are not eligible on their own. This is where problems begin, especially when a working spouse is older than a non-working spouse. Say the working spouse turns 65, retires, and claims Medicare.

How does COBRA affect Medicare?

In this situation, Medicare is always primary to COBRA coverage. If you become entitled to Medicare after you've signed up for COBRA, your COBRA benefits cease. (But if COBRA covers your spouse and/or dependent children, their coverage may be extended for up to 36 months because you qualified for Medicare.)

Is COBRA always 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.

Do I need Medicare Part D if I have COBRA?

Typically, COBRA is not creditable drug coverage for Part D. However, if your plan is an exception, you'll have a Special Enrollment Period to join a Part D plan without a penalty. Refer to your plan administrator to confirm the creditability of your current drug coverage.

Can I drop my spouse from COBRA?

There is no qualifying event that triggers offering COBRA when an employee makes a voluntary choice to drop dependents from the health insurance plan during open enrollment. Generally, COBRA requires that an employee, spouse or dependent child be covered by the plan the day prior to the qualifying event.

Can I add my spouse to my Cobra insurance?

Q2: What does COBRA do? COBRA requires continuation coverage to be offered to covered employees, their spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to certain specific events.

Can COBRA Be Extended?

Consumers may also extend COBRA continuation coverage longer than the initial 18-month period with a second qualifying event —e.g., divorce or death— up to an additional 18 months, for a total of 36 months.

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.

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.

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.

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.

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 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.

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.

Can you revoke Cobra coverage?

Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.

How long does it take to get Medicare if you don't have Cobra?

If you’re not going to be eligible for Medicare yourself within 18 months (or up to 36 months, depending on the circumstances), you’ll have to come up with another plan for coverage when your COBRA continuation coverage runs out.

How long can you keep cobra?

In most cases, COBRA allows you to continue coverage for 18 months. 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 ...

How long do you have to pick a new insurance plan after losing your spouse's insurance?

Losing the coverage you had under your spouse's plan will make you eligible for a time-limited special enrollment period in the individual insurance market, on- or off-exchange (note that in this case, you have 60 days before the loss of coverage, and 60 days after the loss of coverage, during which you can pick a new plan).

Is Medicaid a separate program from Medicare?

It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria. In many states, low-income people making up to 138% of federal poverty level are eligible for Medicaid.

Can I get medicaid if my income is low?

If your income is low enough, you may be eligible for government-provided health insurance through Medicaid. In some states, the Medicaid program goes by another name like SoonerCare in Oklahoma or Medi-Cal in California. It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria.

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, ...

How long can you keep Cobra insurance?

However, you're only allowed to retain COBRA coverage for up to 18 months, so if you're worried about finding a new job within that time frame, Medicare may be a better solution. It's also easy to make the case to sign up for Medicare off the bat.

Is it safe to go without health insurance?

Going without insurance is an unwise move in general, but it's especially dangerous during a pandemic. If you're not yet 65, you may have no choice but to sign up for COBRA and retain your existing coverage, albeit at a hefty cost, or otherwise buy a plan on the health insurance exchange.

Is Cobra a good plan for layoff?

Weighing your health coverage options. If you expect your layoff to be temporary and think you'll be employed, with insurance, in the not-so-distant future, then COBRA may be a good solution for you -- provided you can pay for it.

Is it possible to get Medicare if you lose your employer?

If you have health coverage through work that doesn't cost you anything, paying for Medicare makes little sense. But if you've lost your employer coverage, Medicare could be an affordable temporary solution. Ultimately, there's no right or wrong answer, as both Medicare and COBRA have their benefits and drawbacks.

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.

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.

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.

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