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Honored Contributor
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Registered: ‎03-09-2010

Trying to understand Medicare - COBRA wording

In reading our COBRA pamphlet, it says a spouse becomes eligible for COBRA when "your spouse becomes entitled for Medicare benefits, under Parts A, B or both".  

 

What confuses me is the " becomes entitled" part. My spouse would have become entitled to Medicare at age 65, but he continued to work and was covered by his company's insurance plan. Therefore, shouldn't it say his spouse becomes eligible for COBRA when he starts taking Medicare? This all has to do with how many months I can take COBRA and I want to be sure I understand.

 

Yes, I realize the marketplace would have plans too, but our premiums aren't all that bad, even if we paid the entire cost upon his retiring.

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Honored Contributor
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Registered: ‎07-26-2014

Re: Trying to understand Medicare - COBRA wording

@AuntgThe COBRA pamphlet doesn't have a phone # you can call for any questions you may have?

 

@CARMIEis the forum insurance expert.  Hopefully, she'll see your post.

"Never argue with a fool. Onlookers may not be able to tell the difference."
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Registered: ‎10-25-2010

Re: Trying to understand Medicare - COBRA wording

That phamplet is confusing. So is Medicare and the rules for those over age 65 who are still working. There are several rules concerning eligibility and primacy.

 

Most people sign up for Medicare A when they turn 65 even if they are working.  There is no cost for this.

 

 If the employer has less than 20 employees, you, the employee, must pick up Parts A and B, because Medicare will be your primary insurance.

 

If your employer has more than 20 employees, you do not have to pick up Medicare Part B, but most people pick up Part A because it can often pay as secondary to the employers health insurance.

 

I don't know if your DH has Medicare Part A...you didn't say.

 

COBRA coverage is for employees and their families who are who are cancelled from the employers health insurance.  Those who are eligible for Medicare are NOT offered Cobra.

 

COBRA for an employee and their dependents is for 18 months.


If just the spouse or child is cancelled from the coverage because they are no longer eligible through age, divorce, etc, they can have COBRA for 36 months.

 

I am guessing your DH is ready to retire.  If he does, he must go on Medicare Part A and Part B and look for coverage...either a supplement or Advantage Plan  ( his employer might offer a pan through his retirement benefits...most don't)

 

You could choose COBRA for yourself and stay on it for 18 months or until you are eligible for Medicare, whatever comes first.

 

 

 

 

 

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Re: Trying to understand Medicare - COBRA wording

Thanks @CARMIE . Yes, he has had Part A since turning 65. Under what circumstances would the 36 months of eligibility come into play? That portion I quoted had 36 months associated with it and we were hoping it pertained to our situation.

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Re: Trying to understand Medicare - COBRA wording

@CARMIE  to the rescue! onhorse1.gif

"Never argue with a fool. Onlookers may not be able to tell the difference."
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Re: Trying to understand Medicare - COBRA wording

@Auntg   36 months of COBRA is guaranteed for spouses and dependent children if their coverage is cancelled because the employee has passed, got divorced or legally seperated or the child maxes out because of their age.

 

Also, if the employee becomes entitled to Medicare.  That clause is what is confusing for you.  When some employees become eligible for Medicare because their employer has less than 20 people, they must pick up Medicare Part A and B. They don't have a choice.  At that time their spouse and dependent children would be eligible for 36 months of COBRA.

 

This does not apply to your situation, so you are guaranteed 18 months. However, some employers will allow you to extend it to 36 months as a favor to you.  It doesn't hurt to ask.

 

 

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Registered: ‎12-12-2010

Re: Trying to understand Medicare - COBRA wording

@CARMIE 

That's the most understandable explanation I've ever read & I work in the insurance industry...LOL!  I'm a long way from retirement, but your explanation was a good read.

________________________________________________________________________________________________
It isn’t how long you live that matters; it is how well you are prepared to die.
~~Col. Robert B. Thieme, Jr.
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Re: Trying to understand Medicare - COBRA wording

@SurferWife   Thank you.  I worked for a major insurance company for 

over 25 years as a customer service rep.

 

I handled every type of insurance you can imagine, including Medicare.  I have been asked every question you can think of in that time.

 

I really loved doing it and miss my job....but not the drama.

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Re: Trying to understand Medicare - COBRA wording

@CARMIE 

I, too work for a major insurance company, but I'm in IT.  People automatically think I know insurance but I tell them, Nope!, but I do know IT audit & compliance.

________________________________________________________________________________________________
It isn’t how long you live that matters; it is how well you are prepared to die.
~~Col. Robert B. Thieme, Jr.
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Re: Trying to understand Medicare - COBRA wording


@SurferWife wrote:

@CARMIE 

That's the most understandable explanation I've ever read & I work in the insurance industry...LOL!  I'm a long way from retirement, but your explanation was a good read.


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That is so true about @CARMIE , @SurferWife . I was so perplexed and she helped me understand that sentence. Even my DH said "thank her, that makes total sense".