Medicare Blog

why can you not have cobra insurance and have medicare part b

by Nicklaus Nader Published 2 years ago Updated 1 year ago
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If you’re working past 65 and retire later, you MUST enroll in Part B within the first eight months you have COBRA even if your COBRA stays active longer than eight months. This is because COBRA is not credible coverage for Part B. Those who miss this timeframe will incur a Part B late penalty.

Full Answer

How does Cobra work with Medicare?

The parts of Medicare are:

  • Medicare Part A (hospital insurance). Part A covers stays in the hospital, skilled nursing facilities, and other inpatient care settings.
  • Medicare Part B (medical insurance). Part B covers doctor’s visits, ambulance rides, medical equipment, therapies, and other medical services.
  • Medicare Part C (Medicare Advantage). ...
  • Medicare Part D (drug coverage). ...

Can Cobra cause a Medicare Part B penalty?

You are right that people should not wait to enroll in Medicare Part B when no longer working full-time with true company benefits. Enrolling in COBRA does not keep one from the “famous” Medicare Part B penalty. America needs to be aware that this penalty can be extremely costly and will last until you pass away or are no longer on Medicare.

Is Cobra credible for Medicare?

Under current law, COBRA coverage does not count towards creditable prior coverage for Medicare Part B, which means that when your COBRA ends and you decide to sign up for Medicare Part B after the date you originally could have joined, you will face a 10% per year for life penalty on the cost of Part B.

Who is eligible for Cobra?

  • One of the above things happened to the employee.
  • The employee is becoming eligible for Medicare. ...
  • The employee died.
  • You’re getting divorced or legally separated from the employee.
  • You’re a young adult and you’re losing your dependent status with the health plan. ...

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Can you have COBRA and Medicare Part B at the same time?

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.

Do I have to enroll in 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.

Is COBRA creditable coverage for Medicare Part B?

Is COBRA creditable coverage for Medicare Part B? COBRA is NOT creditable coverage for Part B. If you delay enrollment, you'll face lifetime penalties.

Can you have COBRA and Medicare Advantage 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 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 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.

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 ...

Does Medicare cancel COBRA?

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.)

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.

Can I defer Medicare if I have COBRA?

If you keep COBRA drug coverage and it is creditable, you may delay enrolling into Medicare Part D drug plan until your COBRA ends. You will not have to pay a Part D late enrollment penalty, as long as you enroll within 63 days of losing your drug coverage.

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.

Does COBRA apply if you retire?

Retirees may use COBRA Insurance For 18 Months Retirement is a qualifying event. 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.

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 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 does Cobra coverage last?

(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.) Return to Medicare Q&A Tool main page >>.

When does Cobra expire?

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.

Who pays first, Medicare or Cobra?

Who pays first; COBRA, or Medicare? Medicare pays first, except when you have End-Stage Renal Disease. If you have End-Stage Renal Disease, then COBRA pays first. Medicare pays second to the extent COBRA coverage overlaps the first 30 months of Medicare eligibility.

When do you have to enroll in COBRA?

If you’re on COBRA and under 65, you must enroll in Part A and Part B during your Initial Enrollment Period. Your Initial Enrollment Period will begin three months before your 65th birthday. If you don’t join during the seven-month window, you’ll incur penalties.

Can you terminate Cobra insurance?

It’s important to note that your COBRA coverage could be terminated before the maximum period if you become entitled to Medicare after electing to continue coverage.

Can you have cobra and Medicare at the same time?

It’s possible to have COBRA and Medicare coverage at the same time. However, they don’t coordinate the same way as employer coverage and Medicare. When you have COBRA, Medicare usually pays first, and COBRA pays second. However, it’s possible that your group insurance has special rules that will determine the primary payer.

Is Cobra a part of Medicare?

COBRA is NOT creditable coverage for Part B. If you delay enrollment you’ll face life-time penalties. You could choose to have Medicare Part A and B, alongside COBRA. But COBRA wasn’t made for Medicare.

Can you get a special enrollment period with Medicare?

Medicare allows you to qualify for a Special Enrollment Period if you lose your employer’s current health coverage, and you’re Medicare eligible . If you have COBRA when coverage ends, you won’t qualify for a Special Enrollment Period through Medicare.

Is Cobra a creditable insurance?

COBRA is NOT creditable coverage. If you’re Medicare-eligible and have COBRA, you should enroll in Part B. COBRA extends group benefits for a set period of time – up to 18 months. It’s rare for COBRA to be the best option for a Medicare-eligible person. You can usually get better coverage for less money than COBRA.

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 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.”

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 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 ...

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.”

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.

Q. What are my options for healthcare coverage when I retire?

A. Your previous employer is required to provide you with a COBRA option to continue your health plan for a specified period of time, but enrolling onto a COBRA plan if you are eligible for Medicare may result in your being charged a penalty along with other potential issues.

Q. Should I accept COBRA and delay Medicare enrollment?

A. If you are Medicare eligible when you retire, you receive a Special Enrollment Period (SEP). The SEP allows you to enroll in Medicare Part B and Part D once you lose employer-sponsored coverage. The SEP lasts for a total of sixty (60) days from the date you lose coverage as an active employee of your employer.

Q. What is the Late Enrollment Penalty?

A. Those who do not enroll timely onto Medicare be delaying or enrolling onto COBRA instead will face a permanent penalty which will be added to their coverage costs.

Have more questions?

Here at Henderson Brothers, we want to provide you with the best and most accurate information available. You have the right to be correctly informed about your options, and we want to ensure that you are able to make the decisions that are best for you and your family.

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