Have a question about COBRA health insurance

NY Disney fan

DIS Veteran
Joined
Jun 16, 2005
Messages
5,255
Let's say you quit or get fired from a job. Your employment ends on April 30th and you are no longer covered from that point on. You don't get your COBRA papers until 8 business days later. What if you need to use your insurance between the time you leave and the time you receive the papers? Would a doctor reject you?
 
It depends on when your coverage ends. A lot of employers plans will cover you through the end of the month in which separation occurs.....assuming it's earlier in the month you are fine. However, as long as you elect COBRA within your eligible timeframe it is retroactive to the time that you lost coverage (you have to pay for it back to that point as well). Now your coverage doesn't change so you could just give the provider your card as usual and if things are processed quickly you might be active in the system again by the time they process the claim.....or they may require full payment if they catch that it's not valid. However, you can go back and file a paper claim with the insurance carrier if that were to happen for reimbursement. If it's something that is a large expense I would just tell the provider the situation and see if they will work with you.
 
If it were me I would advise my employer in writing before my last employment date that I would like to continue your COBRA coverage.

Your COBRA coverage can be set up so that there is no break in coverage. Advising an employer in writing about taking COBRA gives them the chance to notify the insurance company right away.

Basically you should be covered and able to go to the doctor. You might want to check with the health insurer to see if your ID number will change.
 

If it were me I would advise my employer in writing before my last employment date that I would like to continue your COBRA coverage.

Your COBRA coverage can be set up so that there is no break in coverage. Advising an employer in writing about taking COBRA gives them the chance to notify the insurance company right away.

Basically you should be covered and able to go to the doctor. You might want to check with the health insurer to see if your ID number will change.

This is a good idea....however if payment isn't made they may not be willing to keep it going until it is. As an employer if you don't cancel the coverage, it is used and then payment is never made the insurance carrier will have to go through the headache of trying to get their money back from the provider. I know we have had at least one carrier in the past 10 years who would not allow you to reinstate coverage through COBRA unless payment had been made - now they wouldn't necessarily know but I'm sure in that instance if you went ahead and did it anyway the employer would end up being held responsible for expenses they normally wouldn't be.
 
Actually by law it is your employers responsibility to prove that they gave you the cobra papers. If you don't get it by your last day then they are usually cert. mailed to you. Most employers have the cobra paperwork on the last day. You are to sign that you do or do not wish to continue.......

It's not that easy to just turn off health insurance...... You should call a rep and ask what their perticular plan calls for regarding cobra
 
Actually by law it is your employers responsibility to prove that they gave you the cobra papers. If you don't get it by your last day then they are usually cert. mailed to you. Most employers have the cobra paperwork on the last day. You are to sign that you do or do not wish to continue.......

It's not that easy to just turn off health insurance...... You should call a rep and ask what their perticular plan calls for regarding cobra

This is a very broad statement......most employers I have come across use a 3rd party administrator for their COBRA and it can easily take 2 weeks or more before paperwork is received.

And it is as easy as a click of the mouse to turn off health insurance. (Granted if your policy is a through the end of the month of separation it would still be in effect until then)
 
Just went throug hthis last october. We weer allowed to back fit our cobra insurance. Meaning that we had the ability to go to the doc then pay for it once the cobra kicked in.
 
I thought you had 30 days to accept or decline Cobra coverage? If you choose to take the coverage it just has to be paid within that time period. If you decline then you pay nothing. Therefore if you go to the doctor on day 7 (and you get the papers on day 8) you are still covered as long as you pay your premium in the alloted time.

I remember a post a few weeks ago where previous employers coverage ended on March 31 but new coverage didn't start intil Apirl 30 (or something like that) the person decide NOT to pay for Cobra upfront and hoped they made it until the new coverage kicked in. If, however somethign happened and s/he needed to go to the doctor before the new insurance kicked in she could pay the COBRA premium and still be ok (covered) for that 30 day period.

Did any of that make sense to anyone but me? lol
 
This is a very broad statement......most employers I have come across use a 3rd party administrator for their COBRA and it can easily take 2 weeks or more before paperwork is received.

My employer already told me that I will be receiving the paperwork about 10 days AFTER employment ends and not before.
 
If it were me I would advise my employer in writing before my last employment date that I would like to continue your COBRA coverage.

Your COBRA coverage can be set up so that there is no break in coverage. Advising an employer in writing about taking COBRA gives them the chance to notify the insurance company right away.

Basically you should be covered and able to go to the doctor. You might want to check with the health insurer to see if your ID number will change.
Not necessarily true
Your employer must notify the insurance company that you are now a COBRA eligible participant. Somewhere in the contract the insurance company has xx number of days to get you now as a COBRA participant back into the system. I have an employee that as part of his hiring packet we are paying his COBRA until he is eligible for our plan. The day he received his documents, I Fed-X'd overnight his election form and payment. A week and a half later he goes to fill an RX, no coverage. I call the insurance company, "no record" I call the COBRA management company. The management company sent it to the insurance company the same day but by contract the insurance company in this case BCBS had 7-10 business days to reinstate the participant, retro to their election date.

Actually by law it is your employers responsibility to prove that they gave you the cobra papers. If you don't get it by your last day then they are usually cert. mailed to you. Most employers have the cobra paperwork on the last day. You are to sign that you do or do not wish to continue.......

It's not that easy to just turn off health insurance...... You should call a rep and ask what their perticular plan calls for regarding cobra
If they are smart they never ever use certified mail. The employer does not have to prove you got the documents, they must prove that they sent them to you in a timely fashion - the US Postal Service is considered accurate by the courts and thus all an employer needs is a proof of mailing. Certified Mail actually carrys too much liability.

This is a very broad statement......most employers I have come across use a 3rd party administrator for their COBRA and it can easily take 2 weeks or more before paperwork is received.

And it is as easy as a click of the mouse to turn off health insurance. (Granted if your policy is a through the end of the month of separation it would still be in effect until then)
By Federal Law, your former company or their representative has 15 days to process your COBRA election forms. You then have 45 days to elect said coverage - total of 60 days. You can elect your coverage on the day you receive the documents and are not required to send in payment until the date specified in your election documents. If you opt to do this, make sure that you get that payment in on time and paid in full. The insurance company must begin the process of reinstating you regardless of payment status according to their contract terms. However, if you do not make that payment, they will then cancel your coverage and you will be liable for the bill to any providers that the insurance company may have paid on your behalf.

To answer your original question.
If you opt to elect your COBRA coverage your insurance will be reinstated retro to your cancel date. Note, during the election process it is possible that your claims will be denied because theoretically your coverage was cancelled and until all parties are updated it is assumed you do not have coverage. If this occurs, you can request that all bills be resubmitted.
As my new employee learned, he paid out of pocket for a hefty RX and once he is reinstated he will submit the receipt for processing.

If you are fired for gross negligence, like unemployment it is possible that COBRA can be denied. I have never seen it done, no one really wants that kind of risk.

COBRA is a former employee not employer friendly law. It is the responsibility of the employer to know, implement and follow the law. The employee has lots of leeway in how they elect, when they elect, how they pay and when they pay (to a point) Contact the HR or the adminisitrator with any specific questions you may have.
 




New Posts





Receive up to $1,000 in Onboard Credit and a Gift Basket!
That’s right — when you book your Disney Cruise with Dreams Unlimited Travel, you’ll receive incredible shipboard credits to spend during your vacation!
CLICK HERE








DIS Facebook DIS youtube DIS Instagram DIS Pinterest DIS Tiktok DIS Twitter DIS Bluesky

Back
Top Bottom