COBRA

Everything you need to know about COBRA

COBRA provides the ability for you and the dependents covered on your health plan to keep coverage after you lose your job or lose coverage for other reasons.

You are eligible for COBRA if your employer's health plan covers at least 20 employees and you have had an acceptable "qualifying event."   

A qualifying event is something that causes you or your dependents to lost health coverage, such as termination of employment, loss of full-time status, divorce or legal separation, or turning 26 (in the case of your children.)

If you have one of these events, your employer will notify you of your option to enroll in COBRA coverage within 14 days of the plan ending.  You will then have 60 days to decide if you want to enroll.

You can keep COBRA coverage for 18 or 36 months, depending on the qualifying event.

In general, COBRA only applies to employers with 20 or more employees. 

But, some states require employers covering employers with fewer than 20 employees to let you keep your coverage for a limited time.  This is often referred to as "Mini-COBRA" and you can read more about how Maine handles this here:  https://www.maine.gov/pfr/insurance/faq/cobra_faqs.html
 

Your Employer's Responsibility:

The employer must tell the plan administrator if you qualify for COBRA because of one of these reason:

  • The covered employee dies
  • The covered employee lost her/her job
  • The covered employee becomes entitled to Medicare
Once the plan administrator is notified they must let you know you have the right to choose COBRA coverage.
 

Your Responsibility:

You or the covered employee are responsible to notify the plan administrator if you qualify because of on of the following reasons:
  • You've divorced or legally separated from the covered employee
  • You were a dependent child or dependent adult who is no longer a dependent.
You will need to tell the plan administrator about your change in situation within 60 days of the change in order to qualify for COBRA.
 
 

COBRA and MEDICARE:

Something really great about COBRA that is not widely known is that if the covered employee becomes entitled to Medicare and the spouse is a few years younger, you do not have to keep working to keep your spouse insured.   Your spouse and dependents may keep COBRA for up to 36 months if you lost coverage due to enrolling in Medicare!
 
You may also keep COBRA coverage for services that Medicare does not cover, such as vision and dental. 
 
You may - for example - if you have COBRA dental insurance, the insurance company that provides your COBRA coverage may allow you to drop your medical coverage but keep paying the premium for the dental coverage as long as you are entitled to COBRA coverage.
 
If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA if you choose.   Medicare will be the primary insurance and COBRA will be secondary.  You should keep Medicare because it is responsible for paying the majority of your health care costs.
 
NOTE:  COBRA is typically much more expensive than the most expensive Medicare plans so it makes sense to talk to an agent or broker like myself to know your options before you decide to go with COBRA and compare costs.

 

Read more about working with an agent.

 

 
If you have questions about Medicare or COBRA, you can reach out to me using the CONTACT button on the menu at the top of this website or by calling (207) 370-0143.  You can also reach out to the government agencies below.
 
If you are leaving a government employer contact:
The Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627.
 
If you are leaving a private employer contact:
The US Department of Labor at 1-866-487-2365
Maine DOL: (207) 623-7900
New Hampshire DOL: (603) 271-3176
 
 
If your employer group health plan coverage was from a state or local government employer then call
The Centers or Medicare and Medicaid Services (CMS) at 1-877-267-2323 extension 61565.
 
 
 

Would you like my help?

If you would like help finding the right plan or just want to ask a few questions, you can call me directly at 207-370-0143 or use my simple form on the CONTACT page of this site to send an email message.  The best part about working with me is that it will not cost you anything to talk with me to discuss your options and review the plans that are available.  I am paid by the insurance companies in the form of a commission when you enroll in a plan.  You will not pay anything to meet with me and you will pay the same price for your insurance that everyone pays whether they had my help or not.

"My goal is to help people and I have found great joy in being able to offer my services to people who need my help."

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