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

[lanejudy]

I have 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 when I hit 65 and my info is audited. 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

That is true. I keep a letter from my employer every year to show our health plan is considered "creditable coverage" by Medicare standards. You qualified for Medicare younger than age 65. But even if someone is over 65 and opts to continue on private insurance instead of Medicare they must be able to show creditable coverage from first Medicare eligibility date in order to avoid Medicare late enrollment penalty later. One aspect of creditable coverage is the size of the employer. COBRA is not typically considered creditable coverage; once you lose employer-sponsored health coverage you are eligible for a SEP (special enrollment period) for Medicare unless you enroll in other creditable coverage.

 

[lanejudy]

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!

That's my understanding as well. Condolences for your loss

 

[AnnaS]

That's my understanding as well. Condolences for your loss

Thank you so much.

 

[barkley]

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.

that's the way it was for years with us. I had mediCARE but I also had retiree healthcare from my former employer that covered dh and the kids/was considered secondary insurance for me. my 1st kid (non disabled) aged out of it but with our younger disabled son we had to wait to apply for SSDI when he turned 18 and then wait the 2 years for HIS mediCARE eligibility to kick in.

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.

I had private insurance ppo coverage and mediCARE for years. mediCARE is primary and they bill to that first, then the ppo. only difference in 'rules' is you have to go to a mediCARE accepting doctor (so I just asked the ppo docs if they would accept it when I qualified-no issue since I was an existing patient).

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.

That is true. I keep a letter from my employer every year to show our health plan is considered "creditable coverage" by Medicare standards. You qualified for Medicare younger than age 65. But even if someone is over 65 and opts to continue on private insurance instead of Medicare they must be able to show creditable coverage from first Medicare eligibility date in order to avoid Medicare late enrollment penalty later.

VERY IMPORTANT TO SAVE-i had to provide copies. don't rely on an insurance company or hr at someone's employer to get it if you need it down the line-they send it once a year in accordance with the law and it's your responsibility to retain it. I had the same private insurance for decades but they were forthcoming that they do not retain this information nor are they obligated to do so (one of the times my OCD on keeping old paperwork paid off).

 

[lanejudy]

I had private insurance ppo coverage and mediCARE for years. mediCARE is primary and they bill to that first, then the ppo.

Medicare as primary or secondary depends on whether the non-Medicare plan is retiree benefit or active employee benefit.

 

[LuvOrlando]

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!

I am so sorry for your loss. COBRA is, IMO, usually the best option because when I went looking the Marketplace coverage for a loved one recently every one that looked good always had so very many complaints (check reviews) it looked miserable for very close to the same cost. I know some people do well but, to be honest, I am also not a fan of change when stressed so I would prefer to go with what I know.

No matter what if you have not done so yet I would strongly recommend you make an appointment at your local Social Security office and have a conversation with someone there who can help you understand, the rules are weirdly twisty. There are all sorts of deadlines for things with far reaching consequences that you want to make sure you understand. The people at you local Social Security office usually know everything there is to know and while they won't inform you and will not "lead you" they will answer direct questions so just have direct questions such as, "What form is it I need to have prepared in order to XYZ." There are also Social Security lawyers which usually help a person navigate SSDI requirements but some will also consult for an hour rate that isn't too bad.

If you have Instagram I really like what medicaremama has to say, she is informative in the sense that she gives me topics to go research on my own and is generally helpful.

 

[LuvOrlando]

that's the way it was for years with us. I had mediCARE but I also had retiree healthcare from my former employer that covered dh and the kids/was considered secondary insurance for me. my 1st kid (non disabled) aged out of it but with our younger disabled son we had to wait to apply for SSDI when he turned 18 and then wait the 2 years for HIS mediCARE eligibility to kick in.


I had private insurance ppo coverage and mediCARE for years. mediCARE is primary and they bill to that first, then the ppo. only difference in 'rules' is you have to go to a mediCARE accepting doctor (so I just asked the ppo docs if they would accept it when I qualified-no issue since I was an existing patient).



VERY IMPORTANT TO SAVE-i had to provide copies. don't rely on an insurance company or hr at someone's employer to get it if you need it down the line-they send it once a year in accordance with the law and it's your responsibility to retain it. I had the same private insurance for decades but they were forthcoming that they do not retain this information nor are they obligated to do so (one of the times my OCD on keeping old paperwork paid off).

But I do not want to go to a Medicare Dr, I want to go where I want when I want and I do not want Medicare tying my hands and so if I am ok for paying for the private insurance PPO why on earth is my Gov stepping in to force me to bring Taxpayer money into it? Why would my Gov do that? Isn't it in Taxpayers best interests to leave me in the private sphere as long as possible, certainly as long as I care to have it this way? Lets say someone wants to devote their 401K to this, just let them. It is weird to me that the Gov is forcing this, no matter how I look at it this makes no sense.

 

[VandVsmama]

But I do not want to go to a Medicare Dr, I want to go where I want when I want and I do not want Medicare tying my hands and so if I am ok for paying for the private insurance PPO why on earth is my Gov stepping in to force me to bring Taxpayer money into it? Why would my Gov do that? Isn't it in Taxpayers best interests to leave me in the private sphere as long as possible, certainly as long as I care to have it this way? Lets say someone wants to devote their 401K to this, just let them. It is weird to me that the Gov is forcing this, no matter how I look at it this makes no sense.

Well, you COULD choose to pay cash out of pocket for all of your healthcare needs. Like, don't have any of it go through Medicare or any other type of health insurance. Usually that's pretty cost prohibitive for most people.

 

[Mommb]

Insurance works best when there is a large pool of people enrolled, so that costs are spread over the entire pool. If people could choose whether to enroll in Medicare at 65, many would wait until their health declined to the point that they needed extensive care. Then they would have high medical expenses covered by Medicare without having paid in premiums while they were healthier and needing less coverage. If a lot of people do this, premiums will go up for those who are enrolled.

COBRA coverage is designed as a temporary plan for people who lose employer-sponsored coverage, generally when they leave a job. If a large number of people 65 and older who leave a job take COBRA coverage on the employer’s plan and then have high medical expenses (given that medical expenses tend to be higher, on average, for people over 65), it will increase the cost of the plan for everyone on it. This is a larger problem for small employers, because they have fewer people to share the costs.

 

[barkley]

Well, you COULD choose to pay cash out of pocket for all of your healthcare needs. Like, don't have any of it go through Medicare or any other type of health insurance. Usually that's pretty cost prohibitive for most people.

so far as I am aware there is no law that mandates a person has to accept mediCARE. there are specific instructions on the mediCARE.gov website that explains how to drop it if a person does not want it but is enrolled. it explains the downsides (like the late enrollment penalties you may face if you enroll down the line) but no law requires being on. the ACA required individuals to have some form of insurance but that got repealed so unless someone lives in new jersey, california, rhode island, massachusetts or the district of columbia which require residents to have insurance or face a tax penalty people can do whatever their heart desires.

 

[AnnaS]

I am so sorry for your loss. COBRA is, IMO, usually the best option because when I went looking the Marketplace coverage for a loved one recently every one that looked good always had so very many complaints (check reviews) it looked miserable for very close to the same cost. I know some people do well but, to be honest, I am also not a fan of change when stressed so I would prefer to go with what I know.

No matter what if you have not done so yet I would strongly recommend you make an appointment at your local Social Security office and have a conversation with someone there who can help you understand, the rules are weirdly twisty. There are all sorts of deadlines for things with far reaching consequences that you want to make sure you understand. The people at you local Social Security office usually know everything there is to know and while they won't inform you and will not "lead you" they will answer direct questions so just have direct questions such as, "What form is it I need to have prepared in order to XYZ." There are also Social Security lawyers which usually help a person navigate SSDI requirements but some will also consult for an hour rate that isn't too bad.

If you have Instagram I really like what medicaremama has to say, she is informative in the sense that she gives me topics to go research on my own and is generally helpful.

Thank you so much.

Many people mentioned the Marketplace at the time and also my DH's company gives you the options of course to look into the Marketplace/shop around. I did it quickly. I do qualify for money off the quoted prices. Tried to compare a few, high deductibles, etc. The grief/mourning is too much even more so then. I could not think clearly and I had so many other matter to take care of that took months. I did not want to risk losing COBRA if I screwed up or did not like what I might have signed up for.

I already have it on my calendar three months before I qualify for Medicare (not this year), to speak to someone. I would like to still have my prescriptions, eye glasses, dental (do they cover dental?) - there is so much to learn and explore. I will most likely pay for a supplement but will discuss with someone who knows more than me first.

Thank you again.

 

[lanejudy]

But I do not want to go to a Medicare Dr, I want to go where I want when I want and I do not want Medicare tying my hands and so if I am ok for paying for the private insurance PPO why on earth is my Gov stepping in to force me to bring Taxpayer money into it? Why would my Gov do that? Isn't it in Taxpayers best interests to leave me in the private sphere as long as possible, certainly as long as I care to have it this way? Lets say someone wants to devote their 401K to this, just let them. It is weird to me that the Gov is forcing this, no matter how I look at it this makes no sense.

Nobody is “forced” by the government to go on Medicare. Take your current situation — you are Medicare-eligible but covered by an employer-sponsored plan. You can be on private insurance for the rest of your life if you so choose.

IF (or when) you decide to switch to Medicare coverage, because you are already Medicare-eligible your premiums may be higher (penalty rate) if you cannot show you had creditable coverage before Medicare. That’s all. It’s all about keeping the lower premiums, not a requirement to force anyone to switch to Medicare.

And unless your spouse is facing a layoff, it all seems like needless worry.

 

[LuvOrlando]

Nobody is “forced” by the government to go on Medicare. Take your current situation — you are Medicare-eligible but covered by an employer-sponsored plan. You can be on private insurance for the rest of your life if you so choose.

IF (or when) you decide to switch to Medicare coverage, because you are already Medicare-eligible your premiums may be higher (penalty rate) if you cannot show you had creditable coverage before Medicare. That’s all. It’s all about keeping the lower premiums, not a requirement to force anyone to switch to Medicare.

And unless your spouse is facing a layoff, it all seems like needless worry.

But I am, I was forced to accept A

And it isn't just a layoff, it is the requirement that the person carrying coverage be in a larger business

 

[Allison]

So much misunderstanding on your part.

 

[lanejudy]

But I am, I was forced to accept A

And it isn't just a layoff, it is the requirement that the person carrying coverage be in a larger business

Your Part A benefits are likely not doing much of anything because it’s secondary coverage for hospitalization. There is no premium for Part A.

Does your DH not plan to be on Medicare when he retires? Have you actually looked at premiums and coverage available? As long as the private coverage you have is considered “creditable coverage” then you are fine. And if you never plan to be on Medicare nobody will force you. The issue only arises when you DO apply for Part B (C D etc) coverage.

Again, unless this life event is imminent I think it’s needless worry.

 

[Mackenzie Click-Mickelson]

Pre-ACA when you got kicked off your parents coverage when you graduated college COBRA was about 3X the cost per month than what I got on my own and no I couldn't afford that so I got my own plan. I'm sure the marketplace costs have influenced the price difference but really it's not what your thread is about. I'm going to agree with others but take it a step further you have questions, you feel you're stuck in one choice, I think you need to do the asking to the appropriate parties off the DIS for this one.

 

[CAPSLOCK]

Well, you COULD choose to pay cash out of pocket for all of your healthcare needs. Like, don't have any of it go through Medicare or any other type of health insurance. Usually that's pretty cost prohibitive for most people.

I wish! Stupid Massachusetts requires it

 

[georgina]

My DH has never had a situation where a doctor does not accept Medicare. He goes where he wants when he wants, does not feel Medicare ties his hands in any way. It's a great option for him, much less than I am paying for my insurance through his former employer (and they are charging me the employee rate).

 

[Mommb]

Pre-ACA when you got kicked off your parents coverage when you graduated college COBRA was about 3X the cost per month than what I got on my own and no I couldn't afford that so I got my own plan.

It is still true that COBRA coverage can be very expensive. I covered my son along with my daughter, husband, and me for around $400 per month, subsidized by my employer. When my son reached 26 and could no longer be covered as part of my plan, he was offered a rate of $780 per month to continue his coverage under COBRA, because it was no longer subsidized. He found other insurance.

The level of subsidy varies by employer, and may be less for smaller employers so the increased cost of COBRA coverage is less. I just wanted to point out that COBRA coverage may not have the same cost as the same coverage through an active employee.

 

[VandVsmama]

It is still true that COBRA coverage can be very expensive. I covered my son along with my daughter, husband, and me for around $400 per month, subsidized by my employer. When my son reached 26 and could no longer be covered as part of my plan, he was offered a rate of $780 per month to continue his coverage under COBRA, because it was no longer subsidized. He found other insurance.

The level of subsidy varies by employer, and may be less for smaller employers so the increased cost of COBRA coverage is less. I just wanted to point out that COBRA coverage may not have the same cost as the same coverage through an active employee.

Agreed. COBRA health insurance coverage IS quite cost prohibitive. So before the average person thinks of what the cost might be, that person often will assume that whatever the monthly rate is that they're currently paying as a regular employee will be what they'll pay for COBRA coverage.

No.

With COBRA coverage, the amount you pay per month for the insurance premium is the amount you paid while still employed PLUS the amount per month that your employer chipped in for the insurance premium.

And for a family, that could result in literally thousands of dollars per month out the door. Many people don't have that $$ sitting around to use for such a situation.