I am considering retirement at 63 & 1/2 years of age. I understand that I would be covered under COBRA until at age 65 when Medicare kicks in. My question has to do with my wife, who would be 61 at the time I retire. Since COBRA seems to have a 36 month limit, would she be covered until she becomes 65 and eligible for Medicare? Would the trigger for a spouse apply when I become eligible for Medicare to extend the time of her coverage, or would we have to find a private plan for that extra year?

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The Consolidated Omnibus Budget Reconciliation Act (COBRA) requires that employees may elect COBRA health insurance coverage from the date of the qualifying event for a limited period of 18 or 36 months.

The length of time depends on the type of qualifying event that made you eligible for COBRA continuation coverage. The group health plan, may provide longer periods of coverage beyond the maximum period required by law.

When the qualifying event is the covered employee’s termination of employment or reduction in hours of employment, qualified beneficiaries are entitled to 18 months of continuation coverage.

When the qualifying event is the end of employment or reduction of the employee’s hours, and the employee became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the employee’s spouse and dependents can last until 36 months after the date the employee becomes entitled to Medicare.

For other qualifying events, qualified beneficiaries must be provided 36 months of continuation coverage.

Is COBRA Right For You?

There are alternatives to COBRA continuation available. Get an affordable insurance quote or call us at 877-262-7241 and we can help you find an ACA certified health plan.

What you need to know

• Employees (or former employees) must generally pay the full amount of the insurance premiums and, if applicable, an administrative fee
• Qualifying events can include:
  • Voluntary and involuntary job loss
  • Reduction in work hours
  • Death of the employee
  • Loss of dependent status
  • Divorce or legal separation of employee and their spouse
  • Employee becomes entitled to Medicare
• Your employer (or former employer) is responsible for providing:
  • Notifications
  • Billing
  • Payment collection

Typically, your employer will work with a COBRA provider (such as us) to handle the required tasks.

Frequently asked questions (FAQ)

Q: What is the Outbreak Period?
A: The Department of Labor (DOL), the DOL Employee Benefits Security Administration, and the Department of the Treasury (the “Agencies”) recently released guidance to provide relief for certain COBRA deadlines during the COVID-19 Outbreak Period. These deadlines are disregarded from March 1, 2020 until 60 days after the national emergency ends (official date yet to be determined).

Q: Can I have an extension to elect COBRA or pay my premium?
A: Yes, as of March 1, 2020 and throughout the “Outbreak Period”, deadlines are disregarded. As a reminder, these extensions do not apply to deadlines ending prior to March 1, 2020. For example, the following deadline expirations would still apply:

• Cancellations for non-payment of the January 2020 premium (deadline date: January 31, 2020);
• COBRA elections that must be made on or before February 29, 2020 (deadline date: 60 days from the date the notice was first mailed or loss of coverage date, whichever is later)

Q: My original COBRA election and/or premium payment deadline is during the Outbreak Period, so what is my new deadline?
A: We will not know the exact date until the federal government declares the COVID-19 national emergency has ended. Any days during the “Outbreak Period” are disregarded.

Q: Will I still have COBRA coverage while my payments are pending?
A: While you cannot be denied from receiving treatment, you may be expected to pay out-of-pocket and then file for reimbursement once your premium payment is made. It is not clear whether an insurer may decide to suspend coverage until you pay the COBRA premium and then reinstate your coverage once your back-premium(s) for those periods are made.

Q: My loss of coverage was not related to COVID-19, am I still eligible for the deadline relief?
A: The current guidance does not specify eligibility requirements for qualified beneficiaries to receive this relief.

Q: Can I stop my coverage for one month since my provider’s office is closed?
A: No. While COBRA coverage is month-to-month (i.e., you can stop it at any time), it is also continuous. If your coverage is canceled (for example, due to non-payment of premiums) it cannot be reinstated.

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Q: Can I use health savings account (HSA) funds to pay my COBRA premiums?
A: Yes, you can use HSA funds to pay COBRA premiums. Transaction fees may apply.

Q: I just enrolled in company benefits, so why did I receive a COBRA letter?
A: Employers are required by law to provide the COBRA General Rights Notice to you and all individuals enrolled in the company’s health plan. This requirement informs you of your rights under COBRA law and explains how you can enroll in COBRA if needed. The notice does not require any action from you.

Q: How much time do I have to elect COBRA coverage once I become eligible?
A: You have 60 days to elect COBRA coverage, from the date the notice was first mailed or loss of coverage date, whichever is later. You also have 45 days from the date you enrolled in COBRA to pay the first premium. These deadlines are disregarded from March 1, 2020 until the end of the Outbreak Period.