COBRA coverage and enrollment question

[jack3454]

Caveat, NOT an agent.

So, if they are messing around trying to save money, the next question might be, is the Cobra coverage creditable for Part D?

I think, if it is, they would have 60 days from end of Cobra coverage to enroll in Part D.

It’s not creditable, so yeah they’d have to enroll in D within 63 days.

Caveat, not an agent.

On the other side of that is all the posts I see relating to problems communicating with Social Security.

One thing I would suggest is they create mysocialsecurity accounts now, if they have not already done so,

And

MyMedicare accounts as soon as they have part A and can do so.

The other thing, is they probably should expect the possibility of delays in getting Part B if they choose that route. If they are healthy and want to take the responsibility themselves for chasing after Social Security if the Part B enrollment does not go smoothly, that's one thing. If they are ill and need smooth and prompt transfer from Cobra to Medicare, that may be another.

You may want to consider making them, not you, responsible for dealing with Social Security if there are problems.

Also, documentation.
I believe there is an employer attestation form they will need for that delayed part B application.

And

If they delay Part D, they should be prepared to offer the Part D carrier proof of creditable coverage for the time they were on Cobra.

Good point on the MySS account and the creditable coverage doc. I know those can be a pain to get up and running. I definitely will advise them that this is THEIR idea, not mine, to save some money. They seem pretty cool so hopefully theres no issues with this.

and one other thing I forgot about.

Dental and Vision.

If the employer Cobra coverage includes Dental Coverage and Vision coverage SEPARATE from the health policy, they may be able to keep those for the 18 month period.

For example in my case, I was on my wife's employer group plan. That was health with a health carrier, dental with Delta Dental KS and vision with VSP.

The TPA immediately told me I could NOT be on the employer Cobra medical coverage, but there was no problem with me having the Dental and Vision coverage under Cobra for 18 months. That worked very well for me.

Oh thats interesting. Ill have to find out if they have dental and if its a separate policy. Was it expensive for the stand alone dental with your COBRA? Thanks for this!

 

[LostDollar]

It’s not creditable, so yeah they’d have to enroll in D within 63 days.

I am NOT trying to insult you with this, but I don't have enough info to be sure about the facts of your situation.

Just wanted to be sure you had seen response of the employer in some way saying the Health coverage was not creditable for Medicare drug purposes

and

You were not deciding the insurance was not creditable for Part D just because it is Cobra.

 

[jack3454]

I am NOT trying to insult you with this, but I don't have enough info to be sure about the facts of your situation.

Just wanted to be sure you had seen response of the employer in some way saying the Health coverage was not creditable for Medicare drug purposes

and

You were not deciding the insurance was not creditable for Part D just because it is Cobra.

I didn't feel insulted at all, but thanks for the thought. It’s definitely not creditable coverage as per the employer which is why I was suggesting to have them enroll in A and D only, then B before the 8 months are up.

 

[Truce]

COBRA: 7 important facts

www.medicare.gov

They are playing with fire. Suppose they have a massive claim during this penny wise/pound foolish game they are playing.

INSURER: "hey, we noticed you are over 65 and on COBRA, we will pay this $50,000 claim SECONDARY to Medicare because that's the LAW"

Your client: "oh, but we didn't enroll in Part B when we started cobra because the premiums for cobra were lower"

INSURER: "You were eligible. Not our problem if you chose not to enroll due to ignorance or bad advice. We pay secondary based on what we would have paid if you had Medicare. Take this argument to the hospital billing dept"

Do insurers pay primary to Medicare all the time for people over 65 on COBRA? Yes, yes they do. Many claims, large and small, just slip through the cracks and insurers don't have the the systems to separate the COBRA people from the actively employed. And yes for RX COBRA is just fine. But I have seen big medical claims 80% denied for this exact situation and you would never let your client be the one that gets burned. I know it's tempting to take that COBRA offered as something they "earned" for years of service, but don't let them skimp on Part B. If they balk, ask them to get it in writing from the insurer that they will pay primary to Medicare while on COBRA.

 

[Dave G]

Truce:
You are spot on....indeed, delaying Medicare for Cobra can be a dangerous game. Not mentioned yet in the other comments is the issue of "timing" Medicare enrollment with election of Cobra. As I understand it, if you already have Medicare (Part A and/pr Part B) PRIOR to electing Cobra, that is OK. However, if you ADD Medicare (Part A OR Part B) AFTER electing Cobra, then Cobra ends (hope this doesn't happen during a shock claim). Further complicating this "game" is what is the specific wording of the Cobra plan regarding coordination of benefits with Medicare?

The ONLY circumstances I've encountered where electing Cobra made the most sense was someone in the middle of a treatment plan or with a scheduled surgery already approved/pre-authorized. Even then, I impressed on them the need to get off Cobra as soon as possible.

Another situation is high-income folks who want to delay Part B because of IRMAA surcharges and retiring soon. The may be able to delay Part B long enough to safely get to January when Soc. Sec. uses a more recent tax-year to calculate IRMAA, or they may be able to get a reduction based on a qualifying life change event.