I wonder how much medicare costs would be cut if people were allowed to use COBRA?

[LuvOrlando]

I saw in the documentation I got that a person is forbidden to opt out of Medicare for a number of reasons including the size of a spouse's business and if the spouse ends up on COBRA.

These mechanisms seem to protect insurance carriers but hurt the person because they are prohibited from choosing coverage and hurt the US by shifting a loan to the taxpayers. I call it a loan because the thing about Medicare is it is really just a loan that costs taxpayers a ton of money because when you activate Medicare you lose the ability to choose many things and then, in the end, you or your estate gats billed for it anyway so it hijacks your wallet.

The other thing about Medicare is it tends to gobble up many people's entire Social Security Payments so if you get $1000 and you need to pay $250 in taxes and then your premium is $500 you aren't really getting any help.

The more I read the stranger it is because disabled people are forced into the coverage for hospitalizations no matter what, and that bit is the strangest part there is.

 

[Marrila]

I saw in the documentation I got that a person is forbidden to opt out of Medicare for a number of reasons including the size of a spouse's business and if the spouse ends up on COBRA.

These mechanisms seem to protect insurance carriers but hurt the person because they are prohibited from choosing coverage and hurt the US by shifting a loan to the taxpayers. I call it a loan because the thing about Medicare is it is really just a loan that costs taxpayers a ton of money because when you activate Medicare you lose the ability to choose many things and then, in the end, you or your estate gats billed for it anyway so it hijacks your wallet.

The other thing about Medicare is it tends to gobble up many people's entire Social Security Payments so if you get $1000 and you need to pay $250 in taxes and then your premium is $500 you aren't really getting any help.

The more I read the stranger it is because disabled people are forced into the coverage for hospitalizations no matter what, and that bit is the strangest part there is.

Huh? One of the most peculiar posts I've ever read.

 

[MartyParty]

Well...I'll bite. Not going to get into the whole political debate here of red and blue. Instead, I'll just keep it green as in money.

I've been at a constant risk of a job layoff for several years now. Fingers crossed this isn't the year. Last I checked of COBRA for a family the cost was about $2,500 a month or $30,000 a year. Ouch. And COBRA only lasts for 18 months, so that would have to change.

 

[EACarlson]

I saw in the documentation I got that a person is forbidden to opt out of Medicare for a number of reasons including the size of a spouse's business and if the spouse ends up on COBRA.

These mechanisms seem to protect insurance carriers but hurt the person because they are prohibited from choosing coverage and hurt the US by shifting a loan to the taxpayers. I call it a loan because the thing about Medicare is it is really just a loan that costs taxpayers a ton of money because when you activate Medicare you lose the ability to choose many things and then, in the end, you or your estate gats billed for it anyway so it hijacks your wallet.

The other thing about Medicare is it tends to gobble up many people's entire Social Security Payments so if you get $1000 and you need to pay $250 in taxes and then your premium is $500 you aren't really getting any help.

The more I read the stranger it is because disabled people are forced into the coverage for hospitalizations no matter what, and that bit is the strangest part there is.

Very few people would choose to use COBRA as it's almost entirely cost prohibitive, especially if you had good insurance. My mother took a sabbatical and paid COBRA for 16 months. She decided she had to go back to work for a year until she hit 65 and would qualify for Medicare. My FIL did the same thing, he kept working right up until the day he qualified for Medicare.

 

[tvguy]

Some day I may add up all the money I paid into Medicare, and how much money my employer and I paid into Social Security,

I paid into both for exactly 50 years. It is NOT a loan. It is MY money. I doubt I will get all the money I paid in back.

 

[barkley]

I saw in the documentation I got that a person is forbidden to opt out of Medicare for a number of reasons including the size of a spouse's business and if the spouse ends up on COBRA.

These mechanisms seem to protect insurance carriers but hurt the person because they are prohibited from choosing coverage and hurt the US by shifting a loan to the taxpayers. I call it a loan because the thing about Medicare is it is really just a loan that costs taxpayers a ton of money because when you activate Medicare you lose the ability to choose many things and then, in the end, you or your estate gats billed for it anyway so it hijacks your wallet.

The other thing about Medicare is it tends to gobble up many people's entire Social Security Payments so if you get $1000 and you need to pay $250 in taxes and then your premium is $500 you aren't really getting any help.

The more I read the stranger it is because disabled people are forced into the coverage for hospitalizations no matter what, and that bit is the strangest part there is.

-mediCARE does NOT recoup from one's estate upon their death and in fact an estate may be eligible to a refund for any unused portion of prepaid mediCARE part b premiums (mediCAID is a separate program that can go after an estate).

-someone receiving $1000 In social security alone is not likely going to be paying taxes on it unless they (or a spouse) have other sources of income at which time it's still not taxed in full (it's a portion of it).

-someone receiving $1000 in social security alone (single person/no spousal income to consider) is not (or at least SHOULD NOT) be paying ANYTHING in the way of their medicare expenses due to the QMB program-

the QMB Program requires the State to pay the medicare premiums, deductibles and coinsurance of low income Qualified Medicare Beneficiaries. (note: coinsurance is the amount medicare charges the patient).

as far as choice goes-in my experience I have a wealth of choices in Medicare plans vs. what my employers offered.

 

[OrangeBirdGirl]

I as well don't see why many people would continue on COBRA due to the huge costs. Most people I know that have left employment prior to Medicare age just get plans on the marketplace. The only reason I would think I'd continue on COBRA after leaving employment until I started another plan is if I hit my high deductible already then while I know I'm paying a large COBRA premium each month, I don't have a deductible for any medical issues.

 

[LuvOrlando]

So many weird rules that legit force a person onto it, why would anyone want to force people into Medicare?

Any young person on disability should be able to stay with COBRA, I would want to stay with COBRA. It is also forced on people whose insurance comes from a business with less then something like 100 people so anyone whose spouse or any child whose family owns a restaurant or another small business. Think of all the kids who are on disability.

People assume this is only an issue for elderly people, it is not.

I get social Security and I pay taxes on it, mine is not associated with income and I imagine there are many people who are disabled who can get medical coverage elsewhere but are prohibited from doing so, it is strange that I would be forced to drop onto Medicare when we could take it into private.


https://content.naic.org/sites/default/files/committee_related_documents/COBRA%20Warning%20Summer%202022.pdf

https://www.investmentnews.com/reti...for-small-business-owners-and-employees/70843

Why a late enrollment fee?

https://www.aarp.org/health/medicare-qa-tool/signing-up-when-spouse-has-insurance.html

Just makes zero sense to me why anyone would want to force me or any other disabled person onto a taxpayer program when I could be managed privately.

 

[lanejudy]

Any young person on disability should be able to stay with COBRA, I would want to stay with COBRA.

Generally a person <65 with a disability must collect Social Security Disability for 24 months before being eligible for Medicare. COBRA eligibility is only for 18 months. It sounds like your question stems from a specific situation -- how long has the individual been on disability, was the individual employed with benefits, and when did the employment end?

As others have stated, COBRA is usually extremely expensive. Much higher premiums than any Medicare premiums that I've seen. If there is a "life event" one may be eligible for a SEP (special enrollment period) to change their Medicare plan.

 

[LuvOrlando]

Generally a person <65 with a disability must collect Social Security Disability for 24 months before being eligible for Medicare. COBRA eligibility is only for 18 months. It sounds like your question stems from a specific situation -- how long has the individual been on disability, was the individual employed with benefits, and when did the employment end?

As others have stated, COBRA is usually extremely expensive. Much higher premiums than any Medicare premiums that I've seen. If there is a "life event" one may be eligible for a SEP (special enrollment period) to change their Medicare plan.

No nothing specific.

I am disabled, nothing related to income, under 65. I have no income, my DH has income but I m my own person. Currently, I am on regular insurance from DH but with so much in the news lately I was reading up on the requirements again and it struck me as just odd that I or anyone else is compelled to draw on taxpayer money. All insurance is very pricey, COBRA isn't all that much compared to the open market and if I wanted to pay the difference for whatever reason why not? Same goes for young a young family with maybe one child who is disabled. Why make things more messy if the family needs COBRA anyway and family rates are family rates? ALso there is some rule about the number of people working at DH's job.

I'd think the GOV would want to keep me off it as long as possible and if I can afford to stay private & want to do so why not let me? Can't make sense of it. As it is I am on Part A without paying for it. Why in the world does it benefit taxpayers to force me into that?

 

[LuvOrlando]

https://www.kff.org/wp-content/uplo...state-financing-of-medicare-drug-coverage.pdf

 

[AnnaS]

I am paying $683.62 a month for COBRA - I am reading 18 months here. I need it for two years. I thought they stretch it to 36 months....I need to go re-read my papers. I have the same coverage (80%) as I had when DH was alive.

 

[Marrila]

No nothing specific.

I am disabled, nothing related to income, under 65. I have no income, my DH has income but I m my own person. Currently, I am on regular insurance from DH but with so much in the news lately I was reading up on the requirements again and it struck me as just odd that I or anyone else is compelled to draw on taxpayer money. All insurance is very pricey, COBRA isn't all that much compared to the open market and if I wanted to pay the difference for whatever reason why not? Same goes for young a young family with maybe one child who is disabled. Why make things more messy if the family needs COBRA anyway and family rates are family rates? ALso there is some rule about the number of people working at DH's job.

I'd think the GOV would want to keep me off it as long as possible and if I can afford to stay private & want to do so why not let me? Can't make sense of it. As it is I am on Part A without paying for it. Why in the world does it benefit taxpayers to force me into that?

Just my opinion- I believe you are massively over thinking this based on your very unique situation.

 

[LuvOrlando]

Just my opinion- I believe you are massively over thinking this based on your very unique situation.

I don't think so, why can't I do what I feel is in my best interests and avoid passing off my care to taxpayers when I can use the private system with the care I prefer and the choices I can make for myself as long as possible? Why can't everyone else young and disabled or the caregivers of disabled children/ minors?

It makes no sense why my government would coerce people to have care paid for by taxpayers if there is a private option available and preferred.

I don't think it is unique, I expect there are thousands of people like me and children whose families have private insurance through COBRA or through small businesses?

https://advocacy.sba.gov/2023/03/07/frequently-asked-questions-about-small-business-2023/

 

[lanejudy]

https://www.kff.org/wp-content/uplo...state-financing-of-medicare-drug-coverage.pdf

That article is from 2004 so I'm not sure if it's still entirely accurate. Plus it is in reference to Medicare Part D, which is the prescription drug coverage plans. Not all "Medicare" -- Part A (hospital), Part B (office), Part C (complete plans). It also says nothing about COBRA or spouse's business or employer size.

 

[barkley]

Any young person on disability should be able to stay with COBRA,

Think of all the kids who are on disability.

Same goes for young a young family with maybe one child who is disabled.

'young people' and children with disabilities almost NEVER qualify for mediCARE. if they are receiving government connected insurance it's likely mediCAID which is an entirely different program(s). the only ones who do qualify for mediCARE are ADULTS who fall under a very narrow program that links them to their parent's social security earning's records-and they have a 2 year wait after they qualify . my son is one of the extremely rare qualifiers for this program.

 

[lanejudy]

I don't think so, why can't I do what I feel is in my best interests and avoid passing off my care to taxpayers when I can use the private system with the care I prefer and the choices I can make for myself as long as possible? Why can't everyone else young and disabled or the caregivers of disabled children/ minors?

You've lost me completely.

Having a disabled child myself, I've seen nothing that says I cannot have her insured on my family health plan up until age 26. However, if I ever had to pay COBRA rates, I may well opt for something different because it's extremely expensive (at least my employer's plan is). Likewise, my spouse is covered by both Medicare and the family plan, and he did drop Medicare Part D coverage at one point because it was duplicative of the family coverage so a waste of premiums because the benefit was never used.

 

[lanejudy]

I am paying $683.62 a month for COBRA - I am reading 18 months here. I need it for two years. I thought they stretch it to 36 months....I need to go re-read my papers. I have the same coverage (80%) as I had when DH was alive.

It can be up to 36 months depending on the situation. The majority of those who qualify for COBRA is due to employment termination or loss of benefits (hours cut). That is only 18 months eligibility.

36 month eligibility is available death of spouse or divorce. Also if an employee becomes eligible for Medicare which allows the spouse and children to do COBRA.

 

[LuvOrlando]

You've lost me completely.

Having a disabled child myself, I've seen nothing that says I cannot have her insured on my family health plan up until age 26. However, if I ever had to pay COBRA rates, I may well opt for something different because it's extremely expensive (at least my employer's plan is). Likewise, my spouse is covered by both Medicare and the family plan, and he did drop Medicare Part D coverage at one point because it was duplicative of the family coverage so a waste of premiums because the benefit was never used.

I'll find it, there are rules I read about and confirmed when I called to double check that people on SSDI need to follow.

One is about COBRA and the other is about the number of people that need to work at the business the person with insurance employs. I suppose it is possible the people I saw in person and spoke to at the office were wrong about the COBRA but I was extremely direct about both topics because I do not want to ever be in non compliance. My understanding is the Medicare becomes primary so the COBRA is useless because once you say you have medicare you get shuffled to a different set of rules from the PPO and whatever rights are with that are ignored. The happened when I was first disabled. Every time I called for an appointment I was redirected to a Medicare sort of office and that took over everything from prescriptions to Dr appts until I was able to sort through rejecting it.

I have also been collecting a weird form from DH's employer every year because I was also told that when I hit 65 I need to prove that absolutely every prior year DH's employer met the requirements or I get some kind of fine for not using Medicare the whole time when I hit 65 and my info is audited. HR of this small business needs to sign off on number of employees I think, it is weird.This requirement is odd since they don't even have a normal form for it so I use what they told me to use and get it signed by HR. Apparently, I need to prove every single year and with the way small businesses vanish I have no idea how anyone can collect this into.

Point is why suck people into it and why become primary payer if people would prefer private and can pay for it?

 

[AnnaS]

It can be up to 36 months depending on the situation. The majority of those who qualify for COBRA is due to employment termination or loss of benefits (hours cut). That is only 18 months eligibility.

36 month eligibility is available death of spouse or divorce. Also if an employee becomes eligible for Medicare which allows the spouse and children to do COBRA.

I think the way I understand it, since my DH passed 11 months ago, I can stay on it up to 36 months. Hopefully I am reading it right - and don't need a new "event" after being on it for 18 months. I won't need for 36 but way more than 18 . It is what it is either way.

Thank you!