COBRA Insurance via CIGNA Treated as Secondary

[LukeH533591]

Hello, this is been an on going issues with me now for several months. I am over 65, not on Medicare, and I had insurance through my employer. When my work was discontinued, I signed up for COBRA to continue my existing insurance for the last 3 months of 2023. Even though the statement from COBRA and Cigna both state this is the same insurance I had when I was employed, Cigna is only paying as secondary and not covering me as the primary. They are saying that I am "eligible" for Medicare so they will only pay as the secondary even though they know I do not have Medicare. I only continued the insurance for 3 months to continue the year with same insurance until I signed up for Medicare in 2024. How can I get help with this because nowhere in any of the documents was it stated that the purchaced COBRA insurnace thru Cigna would be Secondary. I am being giving the run around by Cigna and no one is helping (not my previous employer nor COBRA). I am at the mercy is Cigna and they are not budging on this. Is there Legal Help with AARP or other resources?

[Tonster521]

@LukeH533591 Take a look at your Summary Plan Description (SPD). If you do not have a SPD, contact your past employer to either obtain a SPD or the procedure for obtaining a SPD. The SPD will contain a Section or paragraph explaining how the Plan coordinates benefits with Medicare. FYI, most Plans carve out Medicare benefits if you are eligible for Medicare. Because you have already attained age 65 and stopped working or separated from service, you are eligible for Medicare benefits whether you applied for Medicare or not. Hope this helps.

[GailL1]

@LukeH533591 

COBRA does NOT work well with Medicare.

Medicare.gov- COBRA coverage

It sounds like you are already 65 years old and eligible for Medicare - If you were still working and had access to your employer GROUP coverage you could have signed up for Part A (premium free since most likely you have worked and paid into Medicare thru payroll deductions for long enough to get Part A premium free) and then delayed signing up for Part B and Part D until you lose your employer coverage (not COBRA).

Medicare.gov -How Medicare Works with Other Insurance

Medicare.gov - Medicare and Other Insurance - Your Guide To Who Pays First

You are gonna have to do what is best for you and your situation - cause that will depend on if you are going back to work soon and will you get employer Group coverage.

[LukeH533591]

I was 67 when I signed up for COBRA. The reason I was not on Medicare was because I was running out the remainder of that years insurance since I had already met the deductible? Also, I was seeing if I could find other employment before making the commitment to Medicare. 

[LukeH533591]

Also, has anyone else encountered this? What was done?

[j592491o]

I’m going thru this exact scenario right now. In fact, I am replying from the Medicare waiting area! My employer never provided me the info regarding Cigna vs Medicare. If they had I would’ve signed up for Medicare sooner. They downsized in May and then paid for my extended benefits thru July 31st. I had Medicare kick in Aug 1st. Then all my June and July doctor bills started getting declined. Unknown where this will take me, but I cannot help but feel had I been given the proper information at my exit interview. I would be in a better place today.

[GailL1]

When (at what age) did you sign up for COBRA?  If you were already 65 and eligible for Medicare then you should have signed up for Medicare instead of COBRA - 

[LukeH533591]

I was 67 when I signed up for COBRA. The reason I was not on Medicare was because I was running out the remainder of that years insurance since I had already met the deductible? Also, I was seeing if I could find other employment before making the commitment to Medicare. No where in the COBRA document I was given nor my questions with COBRA was it stated that the insurance I was purchasing was seconday. I feel that should have been communicated. If it was, I would not have chosen COBRA.

[GailL1]

Did you know you were suppose to sign up for Medicare at age 65 even if you were still working - and if your employer coveage was GROUP employer coverage, you could have delayed all or some of the Parts of Medicare until you stopped working.

When you do that, Medicare tell you how it will work with your employer insurance - primary or secondary depending on the number of employees in the Group plan,

Read the Medicare COBRA link I gave to you in my other post - It says:  

How does COBRA work with Medicare?

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. Contact your COBRA plan and ask what percent they pay. 

Avoid gaps in coverage & the Part B late enrollment penalty
If you have COBRA before signing up for Medicare, your COBRA will probably end once you sign up. You have up to 8 months after you stop working (or lose your health insurance, if that happens first) to sign up for Part B without a penalty, whether or not you choose COBRA. If you miss this period, you'll have to wait until January 1 - March 31 to sign up, and your coverage will start the month after you sign up. This may cause a gap in your coverage, and you may have to pay a lifetime Part B late enrollment penalty. To avoid unexpected medical bills, you may need to sign up for Medicare as soon as you are eligible. Contact your State Health Assistance Program (SHIP) for free, personalized help with this decision.

I believe your problem is that you didn’t sign up or even learn about Medicare when you were 1st eligible and when this happened, you evidently didn’t know you were eligible for Medicare.

I hope you are now enrolled in all the parts of Medicare - Part A, Part B and Part D - because there is a time specific time for your to sign up or youi will be paying a late enrollment penalty and it last forever for Parts B and Part D.

If you don’t understand Medicare - Start Here 

“Medicare and You” you can choose your favored format

https://www.medicare.gov/medicare-and-you