By Andrew L Hibbard
@WNYMrMedicare
Originally Posted: 15 MAY 2023
Updated & Revised:
First things first…if you can avoid having to buy costly COBRA insurance, go out of your way to do so.
Why?
Because while buying COBRA insurance allows you to keep the same coverage you had while working, the price you will pay will skyrocket since you will now have to pay both the Employer’s share and the Employee’s share of the cost.
The Background: COBRA, which stands for the Consolidated Omnibus Budget Reconciliation Act of 1985, is a federal law that requires companies with 20 or more employees to let retirees have the choice to continue their group health insurance coverage up to 18 months after they, or their spouse, leave their job and stop active employment.
Here's how it works…
If your Employer hasn’t disclosed how much they are actually paying on your behalf, it's generally 70 percent to 80 percent of the monthly premium price for current, active employees.
So, for example, if your payroll deduction for your Employer Group Health Plan (EGHP) is $100.00 per pay period (or, say, $200 month), that means your Employer is likely paying $700.00 - $800.00 on your behalf behind-the-scenes.
When you choose to enroll in COBRA, you would have to pay both the $200.00 you’re used to paying, PLUS the $700.00 - $800.00 your Employer was paying. Pricey!
The most common reason for COBRA is this…
If you retired before turning 65, and aren’t yet Medicare Eligible, COBRA may be your best, and only, option to bridge the gap until you can make your move to Medicare.
When you turn 65, your COBRA coverage with end immediately, no matter how many months of COBRA coverage you elected from your Employer (remember up to 18 months).
And, Medicare will NOT inform you to sign up and start your Medicare coverage when COBRA has ceased, which means it is critical and crucial you have your plan plotted so you know how to get where you need to go --- and when --- with Medicare.
Now, what if you willingly work past 65, and did not sign up for Medicare?
You can technically buy COBRA coverage if you retire after 65, as long as you also enroll in Medicare Part A and Medicare Part B.
You are required to sign up and start Medicare immediately after stopping active employment because COBRA is considered secondary coverage. Without Medicare as your primary payer, many medical claims may be denied and not paid leaving you responsible for paying the bulk of the bills.
Not a risk you want to take, right?
In this situation, while you may have the choice to buy COBRA coverage, in most cases, most of the time, if you have to sign up and start your Medicare Part A and Medicare Part B benefits (which means paying for them), it is likely more financially favorable to look at a private Medicare insurance plan (Medicare Advantage, Medicare Part C, Medicare Supplement, or Medigap) when comparing out-of-pocket costs and coverage against COBRA cost and coverage.
The Bottom Line: COBRA is not considered “credible coverage” under the IRS and CMS (Center For Medicare Services) rules and regulations.
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ABOUT THE AUTHOR
Andrew L Hibbard is a prominent name when mentioning Medicare in WNY, but one you may have never heard of. Working behind-the-scenes, he is a best-selling author, expert advisor and successful agency owner. Focused on educating first, Andrew prides himself on being considered “the only advocate in WNY fighting for better and more reliable Medicare resources, free from insurance company conflict of interests.”
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