What is COBRA?
What happens if I have COBRA and enroll in Medicare?
What happens if I am in Medicare and choose to get COBRA?
Who pays first, Medicare or my COBRA continuation coverage?
Who should
I call if I have questions?
What is COBRA (The Consolidated Omnibus Budget
Reconciliation Act of 1985)?
COBRA is a law that requires employers with 20 or more employees
to let employees and their dependents keep their group health
coverage for a time after they leave their group health plan
under certain conditions. This is called continuation coverage.
You may have this right if you lose your job or have your
working hours reduced, or if you are covered under your spouse's
plan and your spouse dies or you get divorced. COBRA generally
lets you and your dependents stay in your group health plan for
18 months (or up to 29 or 36 months in some cases), but you may
have to pay both your share and the employer's share of the
premium. Some state's laws require employers with less than 20
employees to let you keep your group health coverage for a time,
but you should check with your State Department of Insurance to
make sure. In most situations that give you COBRA rights, other
than a divorce, you should get a notice from your benefits
administrator. If you don't get a notice, or if you get
divorced, you should call your benefits administrator as soon as
possible.
What happens if I have COBRA and enroll in Medicare?
If you already have group health coverage under COBRA when you
enroll in Medicare, your COBRA may end. The length of time your
spouse may get coverage under COBRA may change when you enroll
in Medicare. For more information about group health coverage
under COBRA, call your State Department of Insurance, (see pages
31- 33).
What happens if I am in Medicare and choose to get COBRA
coverage?
If you elect COBRA coverage after you enroll in Medicare, you
can keep your COBRA continuation coverage. If you have only
Medicare Part A when your group health plan coverage based on
current employment ends, you can enroll in Medicare Part B
during a Special Enrollment Period without having to pay a Part
B premium penalty. You need to enroll in Part B either at the
same time you enroll in Part A or during a Special Enrollment
Period after your group health plan coverage based on current
employment ends. However, if you have Medicare Part A only,
sign-up for COBRA coverage, and wait until the COBRA coverage
ends to enroll in Medicare Part B, you will have to pay a Part B
premium penalty. You do not get a Part B special enrollment
period when COBRA coverage ends. State law may give you the
right to continue your coverage under COBRA beyond the point
COBRA coverage would ordinarily end. Your rights will depend on
what is allowed under the state law.
Remember, enrolling in Medicare Part B will also trigger your
Medigap open enrollment period. To make sure you understand
about this, you should call 1-800-MEDICARE (1-800-633-4227, TTY/
TDD: 1-877-486- 2048 for the hearing and speech impaired) and
ask for your free copy of the Guide to Health Insurance for
People with Medicare. You can also call your State Health
Insurance Assistance Program (see pages 31- 33).
Who pays first, Medicare or my COBRA continuation coverage?
If you or your spouse are age 65 or over and have COBRA
continuation coverage, Medicare is the primary payer. If you or
a family member has Medicare based on a disability and COBRA
continuation coverage, Medicare is the primary payer. However,
if you or a family member have Medicare based on ESRD, COBRA
continuation coverage is the primary payer for a 30-month period
and Medicare is the secondary payer.
Who should I
call if I have questions?
You should call your benefits administrator for questions about
COBRA coverage and payments. If you have Medicare questions,
call 1-800- MEDICARE (1-800-633-4227, TTY/ TDD: 1-877-486-2048
for the hearing and speech impaired). After January 1, 2001 you
should call the Coordination of Benefits Administrator at
1-800-999-1118.
