Cobra Insurance

I just found out that one of the medicines that Bobbie is on cost $2905.34 for a three months supply. Now I couldn't afford this and was wondering if anyone knows about cobra insurance. Where I work I get the three months supply for only $20. I am thinking of retireing and staying at home with Bobbie to provide more assistance to her but I would have to use Cobra Insurance for about 18 months. I know the premiums would be high but I wonder if I would have the same coverage as for as medicines. I have done some internet searches but can't find this information. Anyone ever used cobra before I would appreciate any info.

Jim, if this is the same COBRA I recall from my agent days, it isn't a single company but a set of guidelines for companies which fall into certain categories. It came into being in the 80s, as the feds attempted to level the playing field for all classes of insureds in the US. And if it is that COBRA, it still varies in the way it is actually administered in the different states. Whatever it is, I think your best bet to get accurate information is to call your state insurance commissioner's office. In Texas, the commissioner's office is traditionally partial to insureds, and regulates the companies operating in the state. You can get reports about percentages of claims filed annually, how they are settled, how many are in dispute, what the company's actual track record is. You might also check the feds' websites for more general information about the acronym COBRA. There are often ways to protect yourself against loss in the period after you leave a group and before your conversion or replacement policy kicks in. Sometimes this is tricky. If you know an insurance agent who understands your state regs and will shoot straight with you, have him over for coffee or lunch or breakfast soon. Some of the best agents love a warm visit when there is no pressure to sell.

Jim, your COBRA coverage will be identical to what you have now as an active employee. The difference is the cost - instead of your employer paying (normally) 70-90% of the cost, you will pay all of it. That can mean a difference of $100 or less per month vs. $1,000 or more per month.

A good tip to keep in mind is to watch your dates VERY carefully. You'll have a period of time to choose to take out the coverage, then a period of time to make your payment (plus the retroactive amount to the start date.) Your payments MUST be dated AND postmarked by a specific date (usually they're due on the first day of the month, and are late if received after the last day of the month) Do NOT be late - there is no way to reinstate it if your payment is dated or postmarked past the last day of the month. That's important in February - you don't have 30 days, you have until Feb. 28. In case you haven't guessed, I used to administer employee benefits. I *think* these are still the rules but you should check with your plan administrator to make sure.

Jim something else to consider after you have Medicare you can't have Cobra Insurance also. When I left work the Co I worked for let me stay on the Co. Insurance for 18 Mo.and then I got a letter that I would have to go on Cobra Insurance and by that time I had Medicare and checked and was told that you I couldn't get Cobra because I had Medicare.(I was so lucky to have the boss I did or he wouldn't have paid it for me) Ga laws may be different than Ms but that is what I was told. If I could have gotten it the cost would have gone from $100.10 to $597.00. It is much more costly but with the high cost of Bobby's Medicines you might you might want to see if her Dr can get you on a program to help with her medicine.

Jim, that's a good point. My mom is on some expensive meds (not like Bobbies!!) and she contacted the company and they are going to give it to her for free.

For the trivia buffs: COBRA stands for Consolidated Omnibus Budget Reconciliation Act :) The rules are promulgated by the federal government, not individual states. If your employer has employees in more than one state, the state insurance commission has no jurisdiction over how your benefits are administered. Instead, your plans are governed by ERISA (Employee Retirement Income Security Act), federal regulations.

In any case, COBRA coverage is good for a period not to exceed 18 months. It is no longer available if you become eligible for other coverage (through another employer's plan, or are eligible for Medicare.) Your best bet in most cases is to sit down and talk to whoever administers your COBRA benefits, whether that's an internal HR person or an outside administrator.

Cobra helped me out for awhile. For general information-many drug companies have Patient Assistance Programs-that cover certain drugs-your income level may qualify you for free meds from them. Every company that does that has it's own rules, so finding out from the company helps-often doctors do not use this resource. Also, I now get many of my meds from Canada-much cheaper than in US-they do not have all the meds that I need, but enough to make a major $$ difference.

Something else to consider is that if you DO NOT elect to take COBRA coverage and your medical coverage lapses, your wife's condition will be considered a Pre-existing condition. Any new medical insuranse she becomes covered under will likely NOT cover any associated medical expenses, including medication.

As go_vols said, pay close attention to the dates and addresses that you need to send payments in to. There is no grace period with COBRA insurance.

Also, depending upon when you elect COBRA coverage, you may have to pay quite a bit at one time as your coverage will be retroactive to your last day at work. Sometimes it can be more than a month and a half, so be prepared for some scary dollar signs to confront you.

Go_vols and I both worked in Human Resources, so we have some experience with this. I was responsible for overseeing Benefits, so I dealt with COBRA on a daily basis.

Wow, Thanks for all the information. I knew some of the information about it being goverment regulated and the 18 month coverage. A friend today told me to contact the state insurance comm. office and I think that was mentioned by Aimee. It is harder to retire than I once though it would be. I tried to talk my employer into working part time but I could only make $11,200 a year and still draw SS. I would have to work 30 hours a week to keep insurance and that would put me way over that amount. I also knew that in some cases the Drug companies help out. When Bobbie started on this the maker off the drug(copaxon) called us and told us if we didn't have insurance they had a program to help out. I didn't ask for information because I had insurance. I think I'll contact them and see. They can't tell me anything but no. Once again I really appreciate all of the information and I knew someone would have a lot of answers. Ya'll came through just like family.
One other question is can my HR office find out how much the premium is before I retire. When I asked them earlier it was like they couldn't find out and only said around $300. Even if I got the meds free I would still have to have coverage until I got 65 which is about 18 months. The SS office said I could earn the $11200 and still draw my benefits starting in Jan. This way I would have two incomes starting in Jan. and I would work probable 4 months until I hit $11200.
THANKS AGAIN EVERYONE AND I WILL KEEP YOU POSTED. Jim

Jim,

The HR office should be able to tell you exactly what you would have to pay for COBRA coverage. The only possible reason they might have for not knowing exact numbers is if they are expecting the rates for insurance coverage to change at the first of the year. Rates typically go up in January, so there could be some question as to the exact cost. Other than that, I see no reason why they wouldn't be able to give you the information you're looking for.

Jim, what a wealth of information here. I just wanted to add that there is sometimes a snafu with the insurance company when you get Cobra. I work in a medical office and people are constantly having problems. I think it's because your coverage terminates with your regular plan and then starts up with the Cobra coverage. Just thought I would give you a head's up so if a snafu happens you can get on the phone with the HR dept. and the ins co.