Can I Get COBRA If I'm on Medicare?

Medicare is a federal health insurance program that provides hospital, medical insurance and prescription drug benefits for people ages 65 or older, qualified disabled people under the age of 65 and people of any age who have permanent kidney failure. The program covers similar benefits that an employer-sponsored group health plan pays. Nonetheless, if you're a Medicare beneficiary and you become eligible for COBRA, you can elect to continue receiving group health benefits as a COBRA participant.

COBRA Continuation Coverage

• The Consolidated Omnibus Budget Reconciliation Act, better know as COBRA, requires group health plans to offer to continue health-care benefits to enrolled employees and their family members upon loss of the employee's eligibility to participate in the group plan. COBRA extends the health coverage that you had as a plan member to cover the costs of inpatient and outpatient hospital care, physician care, surgery, prescription drugs, dental and vision care. COBRA requires plans to offer continued coverage to qualified employees, their spouses and dependents for 18 to 36 months, depending upon the event that causes loss of health coverage.

Medicare Premiums

• Individual health status and finances likely factor into your decision whether or not to elect COBRA benefits in addition to your Medicare health-care coverage. In 2010, the premium for Medicare Part B, the medical portion of the federal coverage, ranged from $96.40 to $353.60 per month, depending upon the enrollee's 2008 annual income. Medicare beneficiaries also paid a $155 deductible in 2010 before Medicare benefits begin. Medicare premium and deductible rates are subject to change every January.

COBRA Costs

• If you're a COBRA participant, a group health plan may cancel your policy after you become eligible for Medicare. However, if you enroll in Medicare before electing COBRA coverage, the group health plan can't terminate your COBRA policy. Continuing to participate in a group health plan under COBRA may allow you to retain benefits for health services that Medicare doesn't cover. As a group plan member, your employer paid a portion of your health-care premium as part of your compensation package. If you elect to continue receiving plan benefits as a COBRA participant, you must pay the full premium, plus a 2 percent administrative fee.

Coordination of Benefits

• Part of your consideration on whether or not to elect COBRA may include determining how Medicare and the group plan through COBRA coordinate the payment of benefits for your individual circumstance. For example, if you're 65 or older or disabled and covered by both Medicare and COBRA, Medicare is the first insurer to pay for a medical claim. However, if you became eligible for Medicare as a result of kidney disease, COBRA is the "primary" payer for the first 30 months that the health-care insurance programs overlap.

Deadlines and Decisions

• State insurance laws, Medicare and COBRA deadlines, and decisions you make about one type of coverage may factor into your out-of-pocket costs as well as the rights you retain. The benefits administrator for the employer that sponsors your group health plan and the coordination of benefits contractor at Medicare may help answer specific questions. The U.S. Office of Personnel Management may be a resource if the federal government sponsors your group health plan. The U.S. Department of Labor may provide guidance if a private employer sponsors your group coverage.