What Does Cobra Insurance Cover for Your Healthcare

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A woman in yoga attire practicing the cobra pose indoors on a yoga mat.
Credit: pexels.com, A woman in yoga attire practicing the cobra pose indoors on a yoga mat.

Cobra insurance is a type of health insurance that kicks in when you lose your job or group coverage.

Cobra insurance covers pre-existing conditions, allowing you to continue receiving medical care without worrying about new conditions being excluded from coverage.

You can choose from a range of Cobra insurance plans, including individual, family, and employer-sponsored plans.

With Cobra insurance, you can expect to pay a higher premium compared to group coverage, but it's still a more affordable option than buying individual insurance on your own.

Curious to learn more? Check out: Benefits of Group Health Insurance

What Cobra Covers

COBRA insurance covers the same benefits your employer's health plan covered you for. This includes medical, dental, and vision plans.

You can keep your existing medical, dental, and vision plans under COBRA. However, you can't add new coverage, like a vision plan, if it wasn't part of your plan before COBRA.

COBRA doesn't cover supplemental coverage, such as disability, life insurance, hospital care insurance, or other types of voluntary coverage. This means you'll need to explore other options for these types of benefits.

Understanding Cobra

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COBRA insurance can be a lifesaver for those who need to continue their health insurance coverage after leaving a job. It provides the same coverage you had under your employer.

One of the key benefits of COBRA is that it allows you to keep your health insurance plan even after you leave a job. This means you can continue to see your same doctors and receive the same health plan benefits.

COBRA may cost you a lot more than your previous coverage, so it's essential to consider your financial situation before signing up. You'll need to pay the amount you were previously paying for coverage, plus a 2% administrative fee added by your employer.

Here are some key points to keep in mind when considering COBRA:

  • COBRA is available for 18 months (or 36 months in some cases) after employment ends.
  • COBRA applies to employees at businesses with 20 or more employees.
  • COBRA allows you to continue on the same medical, dental, and vision plans you had while with your former employer.

Disability Extension

If you or a dependent is certified as disabled, you may be eligible for an extended COBRA coverage period. This extension can last up to 11 months beyond the initial 18 months of COBRA coverage.

If this caught your attention, see: Does Full Coverage Insurance Cover Medical Bills

AC Cobra - 1:18 scale model
Credit: pexels.com, AC Cobra - 1:18 scale model

You'll need to provide a copy of your Social Security Administration Notice of Award letter to the Employee Retirement System (ERS) to qualify for this extension. This letter must include the date that the disability began, which should be specified with the month, date, and year.

ERS will review the date of your disability to determine the start of the extended coverage period.

Children Coverage

If you're a parent, you might be wondering how COBRA coverage works for your kids. If you have an unmarried dependent child, they may be eligible to extend their COBRA continuation coverage beyond the initial COBRA eligibility period.

To get more information on this, you can contact ERS toll-free at (877) 275-4377, TTY: 711.

Medicare Primary Coverage

Medicare will generally pay first if you're enrolled in both Medicare and COBRA. If you're unsure about your specific situation, it's best to review your plan documents or contact your insurance provider for clarification.

Certain plans may pay as if secondary to Medicare, even if you're not enrolled in Medicare, so it's essential to understand how your specific plan works.

Differences Between

A Person Touching a Cobra
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COBRA is a federal law, while Mini-COBRA is a Pennsylvania law modeled after the federal COBRA law.

COBRA applies to employees at businesses with 20 or more employees, whereas Mini-COBRA applies to employees at businesses with 2-19 employees.

Under COBRA, you can continue on the same medical, dental, and vision plans you had while with your former employer, but with Mini-COBRA, you're only required to continue your medical insurance plan.

COBRA allows for the purchase of continuation health coverage for 18 months (or, in some cases, 36 months) after employment ends, while Mini-COBRA is for nine months.

You'll need to pay the amount you were previously paying for coverage, plus the portion of the premium your former employer paid on your behalf, under both COBRA and Mini-COBRA. Your employer can also add an administrative fee, with COBRA allowing a 2% fee and Mini-COBRA allowing up to a 5% fee.

Here's a comparison of the two:

Cobra Costs and Limits

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COBRA can be a costly option, as you'll have to pay the full premium for your coverage, plus an administrative fee. This is because your employer no longer pays for part of the cost of your health insurance.

You'll receive a bill from your COBRA administrator within 14 days, telling you about the COBRA continuation coverage available to you. This is an important step in understanding your costs and limits.

The cost of COBRA can be expensive, depending on the kind of coverage you have. You may pay more for COBRA coverage than you did when you were employed, as your employer no longer contributes to the cost of your health insurance.

COBRA coverage has time limits, ranging from 18 to 36 months. This means it's a short-term solution, and you should explore other options, such as individual health insurance plans.

COBRA coverage can end if you don't pay your premiums on time, or if your former employer stops offering group health plans. It can also end if you get comparable coverage through a new job or become eligible for Medicare.

Here are the reasons COBRA coverage can end:

  • You don’t pay your premiums on time.
  • Your former employer stops offering any group health plans.
  • You get comparable coverage through a new job.
  • You become eligible for Medicare.

Alternatives and Options

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You don't have to stick with COBRA if it's not the best fit for you. There are other health insurance options available, such as no cost or low cost plans, Affordable Care Act (ACA) plans, or short term plans for temporary coverage.

If you're looking for a more affordable option, you may qualify for subsidies on an individual health plan, which could make it a less expensive choice than COBRA.

You can shop for and purchase an individual health plan even when it's not open enrollment time, thanks to special enrollment under the Affordable Care Act (ACA). This means you can find a plan that suits your needs and budget.

If you become entitled to Medicare after signing up for COBRA, your benefits will cease, but your spouse and/or dependent children may be able to extend their coverage for up to 36 months.

COBRA can be expensive, so it's worth comparing the cost and coverage options with individual health plans before making a decision.

Making an Informed Decision

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COBRA insurance may be a good option if you expect to be out of a job for an extended period of time, allowing you to continue seeing your same doctors and receiving the same health plan benefits.

However, it's essential to consider the potential high cost of COBRA, which may be a significant burden.

You can continue your current health insurance plan under COBRA, but only for a limited amount of time, typically 18-36 months.

It's a good idea to compare options, such as individual health insurance plans, to find the best fit for your situation.

Teresa Halvorson

Senior Writer

Teresa Halvorson is a skilled writer with a passion for financial journalism. Her expertise lies in breaking down complex topics into engaging, easy-to-understand content. With a keen eye for detail, Teresa has successfully covered a range of article categories, including currency exchange rates and foreign exchange rates.

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