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Marshall | Cobra coverage between jobs? |
I will be giving my current employer their 2 week notice within the next week or so and I will be taking a new job immediately. My new employer offers benefits once I have been with them for 30 days. I have heard about people who have found ways to avoid paying Cobra during this lapse, is that possible, and is it legal? My wife is 4 months pregnant and I don't want to take any chances with having a lapse in coverage and the new policy not picking us up due to a pre-existing condition (pregnancy)... thanks for your help. |
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Christie
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It's a long, drawn-out answer but yes, there is a perfectly legal way to avoid paying high COBRA premiums.
By law, you must receive the COBRA notification and enrollment form within 14 days of when your medical coverage terminates (usually your last day of employment).
Once you have that notice, you have 60 days to decide whether or not you want to elect COBRA. If you decide to elect it, you send in the enrollment form. You then have 45 days (from the date you turn in the enrollment form) before the premium is due.
If coverage with your new employer becomes effective after 30 days, you should already be covered by the new plan long before you have to return the COBRA enrollment form.
With this scenario, you've got about 30 days when you're not covered at all (because your old coverage is terminated and new coverage hasn't started yet). If it's necessary for your wife to see her doctor during this period, you might be in a situation where you'd have to pay ONE MONTH of COBRA premium, but that would be all.
By playing this "waiting game", you'll only end up paying for COBRA if you have claims during the period of time when you're in the waiting period for your new coverage. One months should be the maximum you'll pay.
As far as your wife's pregnancy being considered pre-existing under the new plan, IT WON'T BE. Under HIPAA law, pregnancy is not considered a pre-existing condition.
Other medical conditions won't be treated as pre-existing, either, as long as you do not have more than a 63 day break in coverage between your old medical plan and your new one.
Good luck with all of it, and with the new baby! |
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Suzanne: YPA
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Christie is 100% correct. She gave a great answer!
I'd like to reiterate that, under HIPAA, pregnancy can NEVER be considered a pre-existing condition, even if the woman didn't have previous group coverage. So you're safe re: that aspect of your concerns. |
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kimieyjean
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Cobra is sooo expensive. My now husband and I had to get married just so he would have health insurance. We had already been together 10 years. His cobra payments were 600.00 a month and we also paid 200 a month in co pays and extra for prescriptions. I know our local health partners has a program for personal insurance. Maybe you could just cover your wife until you get your insurance through the new job. Call around and check into some clinics womens clinics which will see her until you have insurance. There are a few locally here in my town, you may have one close too. |
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Rick
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You will not have to worry about a pre-existing condition being placed on you if you do not take COBRA - as long as you do not have a lapse in coverage of more than 63 days it is a federal law that pre-existing limits can not be imposed.
In addition, you normally have 45 days to elect your Cobra - once you elect it, it goes back to the day after your coverage ended with your previous employer. This means that if you incur an accident, or some medical claim during the Cobra election period, you can elect the Cobra and the claim will be covered.
Make sure you verify your new employers wait period - sometimes they say you have a 30 day wait... but the way it words is "first of the month following 30 days of employment". In this exampler, if you start on the 5th of August - you would not be eligible for benefits until the 1st of October.
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
Hope this helps! |
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SCH
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The only way I know to avoid paying cobra is if your employer automatically covers you thru the end of the month after you have left...
When I left my job because I moved I left on Feb 6th but my benefits continued thru Feb 28th because my company continues the benefits because you always are paying ahead, so I had already paid for the month of Feb at that point.
So the best thing to do is specifically ask before you leave when the beneifts will terminate. Also make 100% sure of the day that your benefits will start...you say after 30 days but the way it usually works is that it starts on the 1st of the month after your 1st 30 days of employment...for you it sounds like you will be starting sometime in the 1st week or 2 of August, this could mean your benefits won't start until October (the reason they do this is most carriers will not let them add a person in the middle of the month due to having to prorate and that is just too complicated for the insurance carriers).
I would say having a wife that is pregnant it is very important to invest in the cobra coverage, if your insurance does not kick in until October she will be 7 months pregnant and that is a lot of visits to miss due to no coverage.
The pregnancy would not be considered a pre existing condition because you would have a HIPPA certificate from your former insurance carrier...insurance carriers are required to cover an existing condition as long as it was diagnosed while coverd under another insurance plan...so if you had diabetes and changed jobs your new insurance must cover it because you were covered under the old plan. Once caviot to this is say your wife was diagnosed with a pregnancy complication while uninsured, costs related to that complication would not be coverd (so if she had to have a c-section because the doctor discoverd a 2nd head while you had no insurance they would probably deny the cost of the c-section and only pay the cost of a vaginal delivery). |
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Breezy365
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I've paid for Cobra a couple of times. I haven't heard there was a way to get around it, but since you'll only need it for 1 or 2 months, I don't think I'd take the chance, unless someone else can tell you what you can do.
I did realize recently though, after being on my current job for 1 1/2 years, no one ever asked me for evidence of continuous coverage. Of course different employers might be different. |
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