Medicare Blog

so why is cobra coverage not counted as being covered by medicare

by Mireille Harvey Published 2 years ago Updated 1 year ago

Is COBRA considered creditable coverage for Medicare?

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.

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 ...

Can you be on Medicare and COBRA 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.

How does Medicare impact COBRA?

If an individual is enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if they are not enrolled in Medicare.

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.

Is COBRA considered continuous coverage?

COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise 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.

Is COBRA always secondary to 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.)

How long can my spouse stay on COBRA If I go on Medicare?

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. Q8: How is COBRA affected if I am disabled?

Can you have Medicare and employer insurance at the same time?

Can I have Medicare and employer coverage at the same time? Yes, you can have both Medicare and employer-provided health insurance. In most cases, you will become eligible for Medicare coverage when you turn 65, even if you are still working and enrolled in your employer's health plan.

Is COBRA considered group coverage?

COBRA coverage is not considered a group health plan based upon current employment. So, if an employee becomes eligible for Medicare but elects not to enroll at that time, believing he or she will enroll in COBRA instead, there are no future “special enrollment rights” for Medicare.

How long can I stay on COBRA when I retire?

18 monthsUnder 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. In some cases, people who opt to use COBRA also have to pay an extra 2% to cover administrative fees associated with it.

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