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COBRA vs. RETIREE MEDICAL

WinniWoman

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So still in the throws of this medical insurance stuff. Now that I pretty much got hubby's taken care of, it is time for me to take care of my own.

I am not going on ACA- at least not right now anyway and probably never, so leave that aside. We are moving soon to another state and the plan through my husband's employer is national and a POS and has a network in our new state. It is a high deductible plan, however and has expensive premiums.

I am trying to decide between COBRA or Retiree Medical which are essentially the same policy through my husband's employer, but the COBRA plan is $17 per month cheaper than the Retiree Medical. Evidently what I found out is the main difference is that COBRA is not effective until the premium is paid. Usually you do not get the bill right away- like 45 days later or something like that, so even though it is retroactive to the date you first become eligible for it, if you should need care before you pay the premium you would have to pay for everything and then get reimbursed by the insurance company afterwards. Right off the bat- I don't like this.

Second, it only lasts for 18 months, but that is ok for me because in exactly 18 months I would be eligible for Medicare.

Also there is a 2% administrative fee tacked onto the premium, but I am not sure if the quote I received includes that or if it will add to that $17 difference, making COBRA just $7 per month cheaper. This I have to find out.

So now for the Retiree Medical- it takes effect right away and there is a 30 day grace period to pay the premium. The only requirement for me to have it is that my husband has to have a policy of HIS through VIA Benefits- which he has his Part D prescription plan through them.

(Another benefit of HIM having his Part D plan through them is that he will get a $60 per month HRA contribution from his employer. Also- when I reach Medicare age, I, too, can go through VIA Benefits for the Part D plan and/or Medigap plan and we will get an additional $60 per month for me in the HRA. This is true whether or not I was previously on COBRA or in the Retiree Medical Plan. What the company does is put the Retiree Medical in suspension mode if I go on COBRA).

Now I have posted about this VIA Benefits company in another thread and it was a nightmare to deal with them for my husband's Medigap policy, causing us to go through the carrier directly for that.The Part D plan went through with just one hiccup of which they were no help with, and neither was the carrier, so I had to file complaints on the carrier with the BBB and Center for Medicare and Medicaid Services to get the carrier to deal with it. I also made a verbal formal complaint on VIA Benefits with my husband's employer. So you get the picture. VIA Benefits has a horrible reputation as noted by the numerous reviews on the BBB and also on the IBM employees Facebook page for VIA Benefits specifically.

But although I initially figured I would go on COBRA, I am now considering going on the Retiree Medical plan just in case I would need medical services before I can pay that premium.Crazy that you cannot pay it right away. I don't get why it is structured like this. Just absurd.

It just bothers me a bit that if I choose Retiree Medical, my husband will have to stay married to VIA Benefits in 2020 when we move for his Part D in the new state (have to deal with them to change it) and also in 2021, and worried we will have another horrible experience with them, just to keep my retiree medical in force until I can get Medicare.

At first I thought saving a few bucks per month with COBRA was better than nothing for the same plan, but now I am not so sure if it has the potential of adding to my stress. My plate is full and i am on the edge.

Has anyone had experience with being on COBRA? What do ya'll think? I am trying to make my life easy as I am under tremendous stress with moving and everything and I don't need anymore.
 
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VacationForever

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From our experience we had no issue with COBRA. The doctor's office would be told by the insurer that the plan was still active after we left the company. The insurer would simply assume that COBRA payment was delayed and continue to authorize treatment for patients.
 

WinniWoman

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From our experience we had no issue with COBRA. The doctor's office would be told by the insurer that the plan was still active after we left the company. The insurer would simply assume that COBRA payment was delayed and continue to authorize treatment for patients.

That would be good, but when I asked my husband’s employer about it today the rep said I would have to pay for services and then get reimbursed. Couple that with the fact that I have no relationship with any providers in our new state it is worrisome.
 

Talent312

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I had the same option, only my COBRA health was the same as Retiree + 2%.
I did COBRA for dental, as it was _much_ cheaper than private, w/o any problems.

So I'd say go ahead and do it, but only if the savings is really meaningful to you.
You prolly won't miss the $$, and sleep better at night knowing you're covered.

.

.
 
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b2bailey

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For a difference of $20/month, it sounds like the non-Cobra option would allow better peace of mind.
 

VacationForever

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I agree that pay a little more to get peace of mind. In our case there was not a second option, COBRA or nothing, or we get private individual insurance.
 

DeniseM

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This exact scenario happened to me: My husband retired and I signed up for COBRA, and it took quite awhile to get it started. Of course, I came down with shingles during the gap and had to pay out of pocket for 2 doctor's appointments. However, once the COBRA was active, it did indeed go back to the first of the previous month, and when my doctor billed them, they paid the bill and my doctor gave me a refund.

Non-COBRA was more than twice as much with a big deductible, so I was happy to get the COBRA for 18 months. Now I'm paying $1,100 per month! o_O
 

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It's weird that a high deductible plan has high premiums. That's actually backwards.

How I would decide is by coverage. If you plan to meet or exceed deductible, go with higher coinsurance after meeting deductible. If you are unlikely to meet deductible, go with best coverage for what services you know you will need. I would not decide it by premium cost. If you are grandfathered into retiree plan regardless, don't decide by that.

yuck on deciding insurance stuff.
 

AnnaS

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When my husband got sick - after his regular 6 month insurance expired (not eligible anymore since he did not put anymore hours into his job), we had to go on COBRA for about two months. We had no medical treatment for anyone in my family during that time that I recall (it was 12 years ago) and if we did, we definitely had no problems.

I would go for whichever is easier and peace of mind. So stressful!!!!
 

WinniWoman

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It's weird that a high deductible plan has high premiums. That's actually backwards.

How I would decide is by coverage. If you plan to meet or exceed deductible, go with higher coinsurance after meeting deductible. If you are unlikely to meet deductible, go with best coverage for what services you know you will need. I would not decide it by premium cost. If you are grandfathered into retiree plan regardless, don't decide by that.

yuck on deciding insurance stuff.

Both the COBRA and the Retiree Medical are the exact same plans.

And as I said the difference in the premiums is minimal.

it’s just the other variables I mentioned that bother me.
 

WinniWoman

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This exact scenario happened to me: My husband retired and I signed up for COBRA, and it took quite awhile to get it started. Of course, I came down with shingles during the gap and had to pay out of pocket for 2 doctor's appointments. However, once the COBRA was active, it did indeed go back to the first of the previous month, and when my doctor billed them, they paid the bill and my doctor gave me a refund.

Non-COBRA was more than twice as much with a big deductible, so I was happy to get the COBRA for 18 months. Now I'm paying $1,100 per month! o_O


That scenario is the type of thing I am afraid of. And not having a doctor yet in the new state that I can work with should I have to deal with it.

One thing is that both plans are identical so it is just a matter of the minimal increase in the premium and the other nuances I mentioned, including the one you experienced.

PS I feel for you paying such a high premium. Just crazy!
 

WinniWoman

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Even COBRA has to be so convoluted when it should be so simple! No reason why you should not be able to pay the premium right away! SMH.,,
 

Quiet Pine

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Has anyone had experience with being on COBRA?
I retired 9 months before being eligible for Medicare, and I moved to a different state, so all new doctors. I went on COBRA and had no problem (beyond the high cost). When I went on Medicare, I was turned down by many doctors who weren't accepting new Medicare patients. (Now many are becoming Concierge doctors.) COBRA was fine for me; I had no choice of a retiree plan.
 

pianodinosaur

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One of the reasons I retired is that I was being forced to treat insurance companies rather than human beings. My office had very few problems dealing with COBRAs and we actively helped our patients with the paperwork in their applications for their COBRAs.
 
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