Medicare Blog

what if coverage for medicare and cobra start on the same day

by Alison Bartoletti Published 2 years ago Updated 1 year ago

That depends on when you become entitled to Medicare: 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.

Full Answer

Can you have Cobra and Medicare at the same time?

You can have COBRA and Medicare together if you were already enrolled in Medicare when you become eligible for COBRA. For example, if you’re 67 years old and using a combination of Medicare coverage and coverage from your employer but then retire or scale down to part-time hours, you could be eligible for both COBRA and Medicare.

When should you sign up for Medicare after Cobra expires?

Therefore — regardless of how many months of COBRA coverage you’re offered — if you’re retiring before or at age 65, you should sign up for Medicare during your seven-month initial enrollment period (IEP), which expires three months after the month in which you turn 65.

Does Cobra pay first Medicare or Medicaid?

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, although some Medicare Advantage plans may provide these benefits.

When do I have to make my Cobra Premium payments?

Not including the first premium payments, all other premium payments must be made within 30 days of the due date (due date is set by the group health plan). Q18: How is COBRA coverage computed and how much will I pay?

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.

What happens to COBRA when Medicare starts?

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.

How does COBRA and Medicare work together?

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.

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 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.

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.

Can you have Medicare and employer insurance 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 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.

Does Medicare coverage start the month you turn 65?

The date your coverage starts depends on which month you sign up during your Initial Enrollment Period. Coverage always starts on the first of the month. If you qualify for Premium-free Part A: Your Part A coverage starts the month you turn 65.

Can I delay signing up for Medicare until the COBRA runs out?

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 health insurance end the day you quit?

When you leave your employer, all of your insurance coverage likely ends. Think carefully about continuing some of the other kinds of coverage you may currently have, like: Disability insurance, Critical illness insurance, and.

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 ...

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 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, ...

What age does Cobra coverage start?

A person that is over age 65, has Medicare Part A and/or Part B and is offered Cobra coverage; A person that is under age 65, accepts Cobra coverage and then becomes Medicare-eligible after enrolled into the plan. (Additional consideration should be given to those with End Stage Renal Disease and coordinating with Cobra coverage)

What is the COBRA law?

The federal COBRA law generally applies to job-based insurance from employers with 20+ employees in the prior year. It applies to health plans in the private sector and those sponsored by state and local governments—but not those sponsored by the federal government and certain faith-based organizations.

How old do you have to be to get Cobra?

Situation 2: Now let's look at a person that is 64 years old and decides to enroll into Cobra coverage.

Can you terminate Cobra coverage?

If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the plan may terminate your continuation coverage. We don’t see this happen very often, but just know that it can by law.

Is Cobra insurance secondary to Medicare?

Recommendation: Any person that is eligible for Medicare and presented with a Cobra offer should immediately become enrolled in both parts of Medicare (A and B). They may certainly accept the Cobra coverage but know that it is secondary insurance to Medicare’s primary role.

Does Cobra pay for Part D?

This is often due to a person taking high priced medications that can be covered through the Cobra insurance plan more economically than with a standalone Part D prescription plan. Additionally, some employers may pay most or all of the Cobra premium for a certain time period for the former employee.

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.

What happens if you get Cobra before Medicare?

I f 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.

What is Cobra insurance?

COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act, helps provide health insurance to employees in certain situations where they may otherwise lose their health coverage for 18 to 36 months . COBRA usually is offered to those who experience a reduction in work hours or lose employment. In this blog we’ll cover all these ...

What is Medicare Made Clear?

Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.

How long can you delay Medicare Part D?

You will have 63 days to enroll in Medicare Part D without penalty once you lose COBRA drug coverage.

How long do you have to enroll in Medicare?

Here are some key things about enrollment to keep in mind: 1 You need to enroll in Medicare Part B once you’re eligible 2 You may be able to delay enrolling in Medicare Part D prescription drug coverage without penalty if you can keep COBRA coverage and it includes creditable prescription drug coverage 3 You will have 63 days to enroll in Medicare Part D without penalty once you lose COBRA drug coverage

Can you delay Part D if you lose Cobra?

If you take COBRA and it does provide creditable coverage, then yes, you may be able to delay Part D without penalty. In this case, you will have 63 days after losing COBRA coverage to enroll in Part D without penalty.

Does Cobra pay for Medicare?

If you do decide to take COBRA, do not drop your Medicare plan. Medicare is your primary insurer, and that won’t change when you take COBRA. Medicare will cover some or all health care costs first. COBRA may pay some costs not paid for by Medicare.

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 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 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 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 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 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.

Who administers Cobra?

The Departments of Labor and Treasury have jurisdiction over private-sector group health plans. The Department of Health and Human Services administers the continuation coverage law as it applies to state and local governmental health plans.

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.

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).

Your first chance to sign up (Initial Enrollment Period)

Generally, when you turn 65. This is called your Initial Enrollment Period. It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65.

Between January 1-March 31 each year (General Enrollment Period)

You can sign up between January 1-March 31 each year. This is called the General Enrollment Period. Your coverage starts July 1. You might pay a monthly late enrollment penalty, if you don’t qualify for a Special Enrollment Period.

Special Situations (Special Enrollment Period)

There are certain situations when you can sign up for Part B (and Premium-Part A) during a Special Enrollment Period without paying a late enrollment penalty. A Special Enrollment Period is only available for a limited time.

Joining a plan

A type of Medicare-approved health plan from a private company that you can choose to cover most of your Part A and Part B benefits instead of Original Medicare. It usually also includes drug coverage (Part D).

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