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.
Does Cobra end when you enroll in Medicare?
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.
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.
How do I terminate my Cobra coverage?
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.
Can my spouse stay on COBRA If I go on Medicare?
If an active employee cancels their employer sponsored coverage after enrolling in Medicare, that is considered a voluntary drop in coverage and the spouse and dependents would not be offered COBRA.
Does Medicare cancel COBRA?
If you become entitled to Medicare after you've signed up for COBRA, your COBRA benefits cease.
Does COBRA stop when you turn 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.
Does COBRA end when you become eligible for Medicare?
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.
What happens to my dependents when I go on Medicare?
Medicare is individual insurance, not family insurance, and coverage usually does not include spouses and children. Unlike other types of insurance, Medicare is not offered to your family or dependents once you enroll. To get Medicare, each person must qualify on their own.
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.
Is COBRA Medicare creditable?
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.
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.
Can you have Medicare and employer insurance at the same time?
Thus, you can keep Medicare and employer coverage. The size of your employer determines whether your coverage will be creditable once you retire and are ready to enroll in Medicare Part B. If your employer has 20 or more employees, Medicare will deem your group coverage creditable.
Can you have Medicare Part B and COBRA?
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 have dual coverage with COBRA?
Each qualified beneficiary has an independent right to elect continuation coverage. This means that if both you and your spouse are entitled to elect continuation coverage, you each can make a different choice.
What is a second qualifying event for COBRA?
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 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 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.
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.
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.
How long do you have to enroll in Part B?
Your spouse and dependents may keep COBRA for up to 36 months, regardless of whether you enroll in Medicare during that time.
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.
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].
Who has jurisdiction over Cobra?
The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS) has jurisdiction with respect to the COBRA continuation coverage requirements of the PHS Act that apply to state and local government employers, including counties, municipalities and public school districts, and the group health plans that they sponsor.
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.
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 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 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.
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.
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 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.
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.
Spouses and Dependents Can Get 36 Months Of COBRA
In other instances where a qualifying event happens, family members may choose COBRA for up to 36 months. If there is a separation, annulment or divorce the former spouse, domestic partner or dependent on the employer-sponsored insurance may continue using it.
Affordable Temporary Health Insurance
If you are fairly healthy and still want to remain insured, alternatives to COBRA insurance may be available based on where you live. Short-term health insurance is a popular option and available in most states.
Table of Contents
Background
- 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 …
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 Social Security Act, and is disable…
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…