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

[LuvOrlando]

I hope the people on here with advice actually make the call to Social Security so they will finally know what they don't know & if they get instructions do share and I will call to follow up and report back.

 

[focusondisney]

I hope the people on here with advice actually make the call to Social Security so they will finally know what they don't know & if they get instructions do share and I will call to follow up and report back.

Most of the people who are replied to you are actually already on Medicare. They know what they’re talking about. But definitely call so you’ll find out what you don’t know.

 

[LuvOrlando]

Most of the people who are replied to you are actually already on Medicare. They know what they’re talking about. But definitely call so you’ll find out what you don’t know.

I am also actually on Medicare because I can't refuse Part A said it a few times that is weird it can't be refused and that is the point of this now sort of funny thread.

I know the rules of Medicare but people keep saying what I know to be true is not true so instead of people just saying I got it wrong it seems more useful to show proof, links or something because when I look I keep finding what I already know. If what I say is not true it should be easy to provide proof.

Personally, I would not disagree with someone without being able to prove I was correct with links that show other information.

If there is no proof it is an opinion so why bother caring about another person's opinion at all? Not my thing, not really sure why other people bother but they do.

 

[focusondisney]

I am also actually on Medicare because I can't refuse Part A said it a few times that is weird it can't be refused and that is the point of this now sort of funny thread.

I know the rules of Medicare but people keep saying what I know to be true is not true so instead of people just saying I got it wrong it seems more useful to show proof, links or something because when I look I keep finding what I already know. If what I say is not true it should be easy to provide proof.

Personally, I would not disagree with someone without being able to prove I was correct with links that show other information.

If there is no proof it is an opinion so why bother caring about another person's opinion at all? Not my thing, not really sure why other people bother but they do.

Yea I’m not sure why I bothered to reply to you either.

 

[Marrila]

I am also actually on Medicare because I can't refuse Part A said it a few times that is weird it can't be refused and that is the point of this now sort of funny thread.

I know the rules of Medicare but people keep saying what I know to be true is not true so instead of people just saying I got it wrong it seems more useful to show proof, links or something because when I look I keep finding what I already know. If what I say is not true it should be easy to provide proof.

Personally, I would not disagree with someone without being able to prove I was correct with links that show other information.

If there is no proof it is an opinion so why bother caring about another person's opinion at all? Not my thing, not really sure why other people bother but they do.

It sounds like you've got it all figured out. Glad you understand the guidelines, rules and restrictions. Cash pay is always an option.
We deal with catastrophic illness at our house. We are beyond grateful for Medicare and our secondary. Without treatment I shudder to think what my husband's life would be like. God bless his doctors.

 

[lanejudy]

I am also actually on Medicare because I can't refuse Part A said it a few times that is weird it can't be refused and that is the point of this now sort of funny thread.

I commented earlier and will ask again — have you actually had any claims paid by Part A? Since your primary insurance is through your spouse’s employer and Part A is hospital coverage, it’s unlikely you have “cost” the taxpayers anything by having Part A. So again your worry about costing taxpayers for your health coverage is unfounded at this point.

 

[VandVsmama]

I am also actually on Medicare because I can't refuse Part A said it a few times that is weird it can't be refused and that is the point of this now sort of funny thread.

I know the rules of Medicare but people keep saying what I know to be true is not true so instead of people just saying I got it wrong it seems more useful to show proof, links or something because when I look I keep finding what I already know. If what I say is not true it should be easy to provide proof.

Personally, I would not disagree with someone without being able to prove I was correct with links that show other information.

If there is no proof it is an opinion so why bother caring about another person's opinion at all? Not my thing, not really sure why other people bother but they do.

Ok, fair point about the showing proof thing. Where in the Medicare/CMS regulations does it state what you say it does? Without proof, what you say is just an opinion. Just like without proof from all the rest of us, what we say is an opinion as well.

 

[eandt]

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.

Last time I checked back in 2015 I would have been able to sign my son up for Cobra for 3 years

 

[tvguy]

I know the rules of Medicare but people keep saying what I know to be true is not true so instead of people just saying I got it wrong it seems more useful to show proof, links or something because when I look I keep finding what I already know. If what I say is not true it should be easy to provide proof.

Personally, I would not disagree with someone without being able to prove I was correct with links that show other information.

If there is no proof it is an opinion so why bother caring about another person's opinion at all? Not my thing, not really sure why other people bother but they do.

Okay, in post #46 you said you don't want Medicare regulating what care you can get and from whom. Whoever told you that is wrong. THAT is the big difference between private insurance (which is what COBRA would be) and Medicare. With COBRA you would be limited to In Network Doctors and Hospitals. Medicare is accepted by almost every Doctor and Hospital in the U.S.

https://www.medicare.gov/basics/get.../compare-original-medicare-medicare-advantage

 

[LuvOrlando]

No, COBRA is PPO if you had PPO because you still keep insurance "as is", I had COBRA PPO when I left my job and was waiting for SSDI so I kept it until I switched to DH with a qualifying event.

When I went on SSDI it was very confusing, after the waiting period I was notified I was placed on Part A even after filling out the form to reject everything and was told, flat out, if you are on SSDI then Part A is mandatory AND it would be primary but there was no reason given. Always thought it peculiar.

Anyone calling to ask to figure out the truth for themselves or just spitballing? It is a simple thing to me. People should be able to choose, no reason for taxpayers to be on the hook for me in Part A as primary if I already have insurance via a spouse. No idea why this is causing a stir unless people with it have never called and asked. If you have it you should call and ask or make an appointment and ask.

The most important thing when dealing with SSDI or Medicare is to ask very clear pointed questions, for some odd reason they offer no information unsolicited, you need to have a direct prompt question to get a direct answer which is a terrible thing for people with mental decline of any kind

 

[Marrila]

No, if COBRA is PPO if you had PP you still keep PPO, I had COBRA PPO when I left my job and was waiting for SSDI.

Anyone calling to ask to figure out the truth for themselves or just spitballing?

You seem to know your unique situation and have an understanding of the rules and restrictions that pertain to you. You don't have to like it, but it's good to understand it.
That's all that matters.
I've never been confused about my coverage.

 

[LuvOrlando]

You seem to know your unique situation and have an understanding of the rules and restrictions that pertain to you. You don't have to like it, but it's good to understand it.
That's all that matters.
I've never been confused about my coverage.

I think the title of the thread indicates understanding but dislike, agreed.

If a person has other options why are they not permitted to go that route? Makes no sense to me.

 

[LuvOrlando]

Sure @VandVsmama
this is what I see on a quick search that is discoverable (I'm sure there is more out there) and which reflects what I have experienced and been told. Again, if anyone has information or forms to use for a different arrangement or anything that says it can be different I am all ears


**The Clawback is between each state and the fed and from what I understand the states are required to pay the fed back a portion of what is paid by Medicare for residents and the individual states have made their own rules on how to claw care paid for back from residents - it has lots of answers as we have 50 states all with different approaches. Going to need to ask your own state and maybe ask an attorney if your family has something worth protecting. Messy topic for sure but worth having some understanding.


Medicare Part A
https://www.ncoa.org/article/ssdi-and-medicare-5-things-you-need-to-know/





Size of business carrying insurance:
https://es.medicare.gov/publications/02179-how-medicare-works-with-other-insurance.pdf






COBRA:
https://www.medicare.gov/basics/get...edicare-basics/working-past-65/cobra-coverage


If you can't opt out of Part A then anyone with SSDI has Medicare

 

[tvguy]

If a person has other options why are they not permitted to go that route? Makes no sense to me.

Each option has rules. When I retired at 64, before I qualified for Medicare, I needed health coverage. Checked "Covered California", our state's version of the Affordable Healthcare Act, I could not get coverage because that plan says you are only eligible if you have no other insurance option. I had COBRA as an option.
The thing that confuses me about your situation is, Regular Medicare offers the best coverage, with the most options and fewest restrictions, at the lowest price. The biggest issue I don't understand is most COBRA coverage is going to TELL you which Doctors you can go to, and require pre-authorizations. Regular Medicare doesn't have that.

 

[barkley]

Each option has rules. When I retired at 64, before I qualified for Medicare, I needed health coverage. Checked "Covered California", our state's version of the Affordable Healthcare Act, I could not get coverage because that plan says you are only eligible if you have no other insurance option. I had COBRA as an option.
The thing that confuses me about your situation is, Regular Medicare offers the best coverage, with the most options and fewest restrictions, at the lowest price. The biggest issue I don't understand is most COBRA coverage is going to TELL you which Doctors you can go to, and require pre-authorizations. Regular Medicare doesn't have that.

some people just don't like mediCARE though I heard allot more complaints about mediCAID when I administered the programs.

 

[LuvOrlando]

Each option has rules. When I retired at 64, before I qualified for Medicare, I needed health coverage. Checked "Covered California", our state's version of the Affordable Healthcare Act, I could not get coverage because that plan says you are only eligible if you have no other insurance option. I had COBRA as an option.
The thing that confuses me about your situation is, Regular Medicare offers the best coverage, with the most options and fewest restrictions, at the lowest price. The biggest issue I don't understand is most COBRA coverage is going to TELL you which Doctors you can go to, and require pre-authorizations. Regular Medicare doesn't have that.

But what is the reasoning for the rules that force a person's expenses off to Medicare? How did this make sense to a person who made the rule?

About the COBRA part.
COBRA is a continuation of coverage therefore, if a person has a PPO before COBRA you keep a PPO with COBRA, it is a continuation of whatever you have no matter what that may be. As a result, if a person on SSDI has coverage through a spouse with a job that meets their needs then why not allow that to continue?

This rule shifting costs to taxpayers is peculiar and I go back to my original thread title, if the rules did not force people off of COBRA how much would it save taxpayers?

 

[tvguy]

some people just don't like mediCARE though I heard allot more complaints about mediCAID when I administered the programs.

I know next to nothing about MediCAID. California runs their own program called Medi-CAL.
I have been on Medicare for almost 3 years after 18 months on COBRA with the same private insurance carrier I had for 20 years.
The difference is amazing. I went from needing referrals and pre-authorization to being able to immediately see a specialist or have a procedure done because, as the Doctors staff and hospitals put it "you're on MediCARE, you don't need to do anything, just make an appointment". My Doctor can recommend a Specialist, or if I want, I can pick almost any one I want.

 

[dizneegirl]

So, if you're receiving SSDI, you're already using/getting "taxpayers money" - I don't see what it matters then that after 2 years, you're now receiving Medicare, unless you have coverage under a "large group health plan."

COBRA isn't a forever kind of coverage... it's basically a gap coverage. And it's generally expensive. I doubt many people (other than you, apparently) would choose it over just going with Medicare.

 

[barkley]

But what is the reasoning for the rules that force a person's expenses off to Medicare? How did this make sense to a person who made the rule?

you will never find an answer for this. we were never given the whys of a particular rule or regulation unless it pertained to the repeal or enactment of a new law or was the result of an individual lawsuit. the SSDI mediCARE part A requirement predates COBRA's enactment during president reagan's administration. if I had to guess on the original basis i suspect it was to provide only for catastrophic medical expenses for those that met the disability criteria for social security (given that part A only covers hospitalization, home or skilled nursing and hospice and was enacted in the 60's with the intent of providing almost exclusively for 'the aged'). part B is considered the 'medical insurance' aspect of mediCARE coverage (it was originally referred to as 'physicans care').

I know next to nothing about MediCAID. California runs their own program called Medi-CAL.

medi-CAL is just what California calls their version of it-joint federal and state program. Washington State calls their version 'apple health'. medi-CAL was hands down the single most complicated program I ever administered.

 

[LuvOrlando]

So, if you're receiving SSDI, you're already using/getting "taxpayers money" - I don't see what it matters then that after 2 years, you're now receiving Medicare, unless you have coverage under a "large group health plan."

COBRA isn't a forever kind of coverage... it's basically a gap coverage. And it's generally expensive. I doubt many people (other than you, apparently) would choose it over just going with Medicare.

I suspect there are many people in the US, including children of insured parents not just a spouse of an insured person, who might be better served by being able to make a choice.

It isn't just COBRA though, there is also the requirement that a person slide onto Medicare if the person who carries insurance works for a business that employs less than 100 people.

I don't know the exact numbers but imagine that if all the dependants and spouses who could be covered by a working adult with COBRA and all the dependants and spouses insured by adults who work for businesses that have less than 100 employees were added up it would be a very big number.

I understand people benefit from it and may want to choose Medicare but to not be allowed to opt out, that is peculiar.