Cobra

[sarahbug79]

Is anyone familiar with how cobra works retroactively? Here's the story dh is leaving his job next week we have insurance through the end of the month. New company starts coverage 11/1 so we have 61 days without insurance. Cobra would cost $2400 for those two months and the insurance would still only pay 50 percent of bills. So today I found out we don't have to sign up for cobra right away. We could hopefully stay healthy and never go to the dr. We could pay for an office visit if we needed one. If we have major health issues still sign up for cobra which would cover us. I know it sounds somewhat risky but is it if the will still cover us?

 

[msmayor]

I am not an expert by any means, but I seem to recall that there are some times when 'continuity of coverage' is very important, I believe as it may relate to pre-existing conditions.

What that means is that in order for the new insurance to be required to cover everything that may be pre-existing, you must prove that you were covered by another health insurance policy right up until the new one went into effect.

I believe that is why when you change insurance, your old insurance is required to send you a letter that states when your coverage began and when it officially ended, as your new insurer may require that information before paying out any benefits.

We are somewhat going through this now. My husband was laid off and we were permitted to keep his insurance coverage as part of COBRA benefits but at employee rates for only a certain period of time. That time frame would have run out in September, at which point we would have 6 more months at the extremely high COBRA rates (the cost would have jumped to $2500/month).

I was lucky that where I work, open enrollment occurred in May for July 1 coverage, so we switched then. I just received the letter from our old insurance that indicated the end date of coverage was 12:01am July 1, the time at which the new insurance covered us.

You may want to double-check the continuity of coverage requirements if anyone in your family has a health issue that they receive regular treatment for.

 

[PrincessSuzanne]

I am not an expert by any means, but I seem to recall that there are some times when 'continuity of coverage' is very important, I believe as it may relate to pre-existing conditions.

What that means is that in order for the new insurance to be required to cover everything that may be pre-existing, you must prove that you were covered by another health insurance policy right up until the new one went into effect.

I believe that is why when you change insurance, your old insurance is required to send you a letter that states when your coverage began and when it officially ended, as your new insurer may require that information before paying out any benefits.

We are somewhat going through this now. My husband was laid off and we were permitted to keep his insurance coverage as part of COBRA benefits but at employee rates for only a certain period of time. That time frame would have run out in September, at which point we would have 6 more months at the extremely high COBRA rates (the cost would have jumped to $2500/month).

I was lucky that where I work, open enrollment occurred in May for July 1 coverage, so we switched then. I just received the letter from our old insurance that indicated the end date of coverage was 12:01am July 1, the time at which the new insurance covered us.

You may want to double-check the continuity of coverage requirements if anyone in your family has a health issue that they receive regular treatment for.

I work in healthcare and this is correct. Continuity of Coverage s very important if you have any health issues that you may need to be seen for on the new coverage, otherwise, youmay have to wait 6 months to a year for pre-existing conditions. Some companies don't allow some things to fall under that, but it's usually only pregnancy.

 

[Pakey]

In answer to the original question, you have 60 days to elect COBRA.

Our health plan has a lot of items that fall under pre-existing conditions. I would check with your new employer's HR department and get a copy of the policy before making any decision to decline your COBRA coverage.

 

[FigmentChick]

I am the controller for my company and HR (and all employee benefits) falls under my purview.

msmayor is correct when speaking about continuity of coverage. One of my former employees is fighting this issue right now. We covered hom through the end of Feb, his new insurance kicked in the 1st of April. However, his new insurance company will now not cover any of his heart issues because he did not have continuous medical coverage.

The new "pre-exisiting condition" law does not take effect until 2013. What this means is: it is up to the new insurer if your pre-exisiting conditions will be covered or not. When I choose coverage for my employees, that is one thing I always make sure is included - that the new company will cover pre-exisiting conditions for a new employee.

I understand COBRA is very expensive - I've had to pay it myself for a few months when my husband was on disability. Not fun.

However, you also must consider that if something major does occur, the insurance company will look at the date that you elected for COBRA coverage and correspond that with the date the incident occured (it is something I have done and will do in the future). You could very well be denied coverage because you didn't opt for COBRA until something occured.

Being without medical is very scary. Another option I would consider is self-insurance, at least for the two months you'll need it for.

Hope this helps!!!

 

[sarahbug79]

I thought the continuation of coverage was 63 days beyond that you would have a gap but if you were only out of coverage less than 63 days it wasn't a problem?

 

[libinatorsmom]

YOu have to be really careful with being covered - you need to have a statement of conintuing coverage to change insurance I think.

 

[clutter]

Years ago, I had an insurance company try to deny coverage for endometriosis as a pre-existing condition. They based it on the fact that even though it hadn't been diagnosed, it likely 'existed.' Seriously. They told me that illnesses such as diabetes and cancers were also on the list.

 

[mistysue]

Unfortunately I'm not good at saving paperwork- but earlier this year we went on COBRA. I do know that we had 45 days from turning in the forms until payment was due. I think we had either 30 or 45 days to turn the forms in.
I *think* if you then don't pay they just cancel it and deny the claims, but if you are seriously considering it- it would be worth investigating if they can come after you for the premiums.

 

[matt98378]

We had about a one month lapse in coverage between jobs. We contacted State Farm and were able to get a temporary high deductible plan for that month. It was much more affordable than Cobra and gave us continuing coverage. So, it might be good to check around.

 

[disprincessatheart]

weve been in this situation a couple of times. Last summer we had a 3 month gap, and we opted to purchase higher deducable coverage online thru blue cross blue shield rather than go without. I think it cost us around $900 a month for a family of 3, no smokers, no health issues, mid thirties and a toddler. You might want to look into separate insurance for the gap instead of cobra so you have continued coverage. We did gamble on 8 days of coverage (for some reason DH"s new coverage kicked in on the 9th of the month) and we held that bcbs bill - once we got past the new date we skipped paying that bill, but we also dont have any pre existing conditions