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Contributor ⭐
October 16, 2024

On COBRA and Medicare (Part A only)

  • October 16, 2024
  • 7 replies
  • 3616 views

I'm 62 and currently on COBRA while I look for a new job. My wife is 69 (retired) and was covered under my ex-employers plan, she currently has Medicare Part A only.

 

I know the COBRA coverage covers my wife as well but I'm not clear if she's REQUIRED to sign up for part B immediately or we can wait until I get a job (or I retire)

 

I greatly appreciate any info/pointers  that clears this up for me!

 

Darrell

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    7 replies

    GailL1
    Community Champion ⭐⭐⭐
    October 16, 2024

    @dp8086 

    You are fine since you are not eligible for Medicare yet.  However, your wife may not be - 

     

    Sometimes, depending on what your COBRA coverage says:

    If you have COBRA and you’re eligible for Medicare but not enrolled, COBRA may only pay for a small portion of the health care services you get, and you may have to pay most of the costs yourself. 

    This may be true for your wife on those health coverage items that are covered by Medicare Part B - like doctor visits and a lot of other stuff.  Part A is the hospital insurance so for the everyday stuff it is Part B.

     

    Also Medicare may not count her COBRA coverage as being a replacement for her Part B coverage, like your employer group coverage was when you were employed with your last employer, and they could assess her a late sign up premium penalty which will last forever.  

     

    A lot of this is dependent on what your COBRA policy says about being eligible for Medicare and how it pays in that regards.

     

    Medicare.gov - COBRA coverage 

     

    If she is gonna go ahead and sign up for Part B and since she is already 69, she will need to get this form filled out by the employer holder of the plan(s) she has had continuous coverage under since age 65.

    CMS.gov CMS-L564 Request for Employer Information 

     

    If she finds that she doesn’t need it now she will later on when does want to sign up for Part B.  This proves she has had continuous coverage under an employer group plan since 65 - and will give her access to signing up for Part B without having to wait for a special enrollment period and perhaps have a lapse in coverage.  The form is pretty much self explanatory.

     

    Good luck in your job search.

     

     

    IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna
    dp8086Author
    Contributor ⭐
    October 16, 2024

    Thanks, unfortunately your reply has many "may not"s, "may have"s, etc..so I'm still not confident we should get part B immediately.

     

    I believe the Cobra coverage will be identical to the coverage I received when employed, which was good, (employer plan, plus Medicare Part A only for my wife)...but I'm not sure, 

    I do have the L564 from my previous employer

     

    My preference is my wife does not get Medicare part B until I retire (we keep Cobra or my future employers plan for both of us)

     

    Thanks again, will keep researching...

     

    Darrell

    GailL1
    Community Champion ⭐⭐⭐
    October 16, 2024

    @dp8086 

    All those “may or may nots” or “may haves” deal with what is in your COBRA contract in how it deals with those who are eligible for Medicare.  Just like other health insurance plans - Just like other employer group plans, how they deal with it should be covered in your COBRA policy.  

     

    DOL.gov- An Employee’s Guide to Health Benefits Under COBRA

     

    Read the part “ What Is COBRA Continuation Coverage?”

     

    The policy or the insurer should tell you whether or not there is a coordination of benefits with Medicare.

    Medicare.gov - WHO PAYS FIRST

     

    This could mean that it is better to have Medicare A & B so that any claims are fully covered.

     

    from the link 

    If you have Medicare because you’re 65 or older, Medicare pays first.

    If you have COBRA and you’re eligible for Medicare:

    • COBRA may only pay a small portion of your medical costs
    • You may have to pay most of the costs yourself.

    Contact your COBRA plan and ask what percent they pay.

    What else do I need to know?

    There may be reasons why you should take Medicare drug coverage instead of, or in addition to, COBRA. If you take COBRA and it includes creditable prescription drug coverage, you'll have a Special Enrollment Period to join a Medicare drug plan without a penalty when COBRA ends.

     

    End- copy/paste from the link 

     

    You can read it from AARP:

    AARP.org updated 01/11/2024 - Do I need to sign up for Medicare if my former employer’s coverage continues under COBRA? 

     

     

    IT‘S ALWAYS SOMETHING . . . . .. . . . Roseanne Roseannadanna