No announcement yet.

COBRA Continuing Coverage - Length of Coverage

  • Time
  • Show
Clear All
new posts

  • COBRA Continuing Coverage - Length of Coverage

    As an emergency physician close to hanging it up after 35 years on the front lines, I'm planning on using COBRA to cover health insurance between age 63 1/2 and 65 when I qualify for Medicare. I will be using my Emergency group's commercial insurance. When I stop working, that becomes a qualifying event. My wife in 2 years younger than myself. I know I can get 18 months of coverage for both of us. My wife is two years younger than myself and I know that I will need to figure out how she will be covered until she is Medicare eligible.

    According to all the documents I've read on the CMS and Dept. of Labor sites concerning the COBRA rules, when I go on Medicare that becomes a Second qualifying event. At this time it appears from everything I've read, that my wife who was covered under my commercial plan, should be able to qualify for a total of 36 months, 18 additional months added on to the initial 18 months. Some guy at the third-party administrator that is managing my COBRA payments said all I get is 18 months total! But that's not what the regulations say, as I read them. I can't seem to get a straight answer to the question: Can my COBRA commercial insurance be extended to 36 months for my covered spouse, when I go on Medicare?

    Does anybody out there know the answer to this question? Endless Google searches fail to give me a definitive answer. Surely someone has come across this issue before.

    Thanks in advance for any insight.
    - Dr. Scott

  • #2


    • #3
      I understand your interpretation. However, I believe Cobra addresses the rights of the employee only. You have rights for coverage offered whether individual or with dependents.
      Once the employee rights are completed, it’s over.
      The company would not have a Cobra obligation to dependents.
      Your spouse has a qualifying event, true. But that event allows her to obtain insurance from any vendor (full enrollment rather than the short term plans). The words “you” doesn’t mean “you and your dependents”. Q4 alludes to it for a dependent losing coverage. I assume you have this:


      • #4
        WCICON24 EarlyBird
        The coordination of cobra and Medicare entitlement is very complicated. No wonder you have confusion.

        I understand the cobra laws will only allow a 36 month period for your spouse if your entitlement to Medicare occurred while you were still employed. In this case, the 36 month timeline would begin at your cobra date, not your entitlement date.
        Since you are describing a situation where you are enrolled in cobra and then become entitled to Medicare, the extension for your spouse does not apply.

        What constitutes a 'qualifying event' is up to your employer and it's health Plan Document. It may have a provision for the situation you are in, as employers can choose to be more liberal with cobra than the law requires.