COBRA & Medicare

[catrose]

So I was laid off from my job of 11 years in August. In September I received my COBRA papers. Because I qualify for Medicare in October, my plans were to continue my dental insurance but not my health insurance.

Today the dental company admits that they've received my application, but they attached another page that says my right to COBRA coverage ends if I apply for Medicare or get coverage through another dental group.

What? I understand the other dental group provision, but Medicare doesn't cover dental. Why would applying for Medicare void your dental benefits? My husband has quite a bit of major work to be done in the next month, so it's urgent.

[still_one]

1. Call the COBRA representative for your company and find out what is going on. You should be able to

carry your spouse under your COBRA plan for 18 months, but it won't cover you once you sign up for Medicare I believe

[catrose]

4. That would work, because he's the one with the expensive work to be done

But he's been on Medicare for years...I carried him on my employer's health insurance. So he can get COBRA from my workplace but I can't?

Should I even try to understand this?

[still_one]

6. That is the way they do it. A spouse can be covered up to 18 months on COBRA, while the principal

can not:

"The following are qualifying events for covered employees if they cause the covered employee to lose coverage:

 Termination of the employee's employment for any reason other than gross misconduct;
or  Reduction in the number of hours of employment.


The following are qualifying events for the spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:

 Termination of the covered employee's employment for any reason other than gross misconduct;
 Reduction in the hours worked by the covered employee;
 Covered employee becomes entitled to Medicare;
 Divorce or legal separation of the spouse from the covered employee;
or  Death of the covered employee.

https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf

I know this sounds weird, but your spouse should be covered for up to 18 months even though you aren't

Contact your COBRA administrator, but I am almost certain your spouse is covered as long as you pay the COBRA premiums for Dental. However, you are not

[catrose]

8. Incredible

I'll send them the check and let them sort it out--and find some kind of dental plan for me before I have to have it.

[trixie2]

2. If Medicare doesn't include dental what does it matter? I understand your plight though.

I am having a very, very hard time with insurance right now. I am on the ACA and my premiums have gone up and up and up. Every time they raised it they reset the clock on my co-pays and yearly deductible. Right now my prescription are $35 each. My premium is 5x what it was. I have to find something cheaper or not have insurance October 1. What I don't like is that there is no dental coverage for adults right now. On healthcare.gov they say you can get Delta but what they don't say is that it only covers children. I continued my dental coverage with Cobra and it was very affordable. It did not interfere with the ACA.

I agree with others to talk to anyone at Medicare. I don't understand why you both can't get dental. Dental care is just as important as medical care. An infection in your mouth can ride throughout your body. It makes no sense to me! Nothing right now makes any sense to me. Just to be clear, I am a very left leaning Democrat.

[trixie2]

3. I found this and it stinks

See this link.

[catrose]

5. Thanks, Trixie

I did see that. But I found on Medicare sites where "you MAY be able to continue coverage for services that Medicare does not provide, like dental..." So I'll be on the phone with them tomorrow, trying to figure out whose choice it is whether or not I continue. As you say, what does it matter? It's not like Medicare is offering its own dental plan. Sigh. The rules, they be rules.

[still_one]

7. catrose, your spouse should be able to continue COBRA coverage even though you won't be eligible

for that COBRA coverage.

It doesn't matter whether your spouse is currently under Medicare or not, as long as you pay the premiums

The following are qualifying events FOR THE SPOUSE and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:

 Termination of the covered employee's employment for any reason other than gross misconduct;
 Reduction in the hours worked by the covered employee;
 Covered employee becomes entitled to Medicare;
 Divorce or legal separation of the spouse from the covered employee;
or  Death of the covered employee.

https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf

and you only have to pay the COBRA premiums for dental in your case for your spouse.

It runs for 18 months

That is why you need to talk to the COBRA administrator who know the rules, not just anyone from HR.

[catrose]

9. That's just weird

when he's been on Medicare for years. But I'll take it. He's the one with expensive work being done (scheduled before we knew I'd be laid off).
Thanks much.

[still_one]

10. and if you look at trixie's link it says the same thing

Once an employee is entitled to Medicare they are no longer allowed to continue on the employer’s group health plan this includes dental and vision. If you have a spouse or any dependants, they may take advantage of COBRA continuation.

Your spouse is covered for the dental work as long as you pay the premiums and sign up within the required period

Trixie's link:

http://cobrainsurance.com/help/questions/235/Can+I+continue+the+COBRA+dental+when+I%27m+entitled+to+Medicare%3F

As for yourself, you may want to consider an individual Dental plan, such as Delta Dental, because for the first year they limit what they cover. Once you have been on the plan for over a year they will cover most or all of it, but it still will not be as good as your employer plan.

[trixie2]

11. (cut/paste) It's not like Medicare is offering its own dental plan

I know! It is absolutely crazy insane!

[catrose]

12. So I called the BCRC number on one of the web pages

Hold time: 40 minutes
Result: We're not the division you're looking for. Call this other number.

No hold time, but equal or more ignorance ("Gosh, why wouldn't you be able to keep your dental COBRA?" ). Person had no idea where I could go for real information.

Put in question at the Medicare Interactive website. I know an employment attorney too. In a few weeks I should see whether my husband's claims are accepted.

Thanks for your advice. I remain cautiously hopeful, at least in my husband's case