COBRA & Medicare Interaction Reference Guide

GBS Health Benefits Compliance

COBRA & Medicare Interaction Reference Guide

The first matrix “Timing of COBRA Election and Medicare Eligibility or Entitlement” includes specific examples of how the timing of the COBRA election and the Medicare entitlement or eligibility can significantly affect coverage duration for both the employee and their dependents.

  • Medicare “entitlement” is synonymous with enrollment in Medicare,
  • Medicare “eligibility” means the individual meets the criteria to enroll, like age and years of covered employment, but has not yet enrolled.

Keep in mind that COBRA coverage could also end for reasons other than Medicare entitlement, for example, if the maximum COBRA period is reached, if the plan ends and the employer ceases to provide any group health plan to any employee, or if the qualified beneficiary fails to timely pay the premium. This matrix only addresses how Medicare affects COBRA.

The second matrix “Medicare Enrollment Periods and Late Enrollment Penalties” details the various Medicare enrollment periods (initial, special and general) and late enrollment penalties, and how these differ for Medicare Part D (prescription drug coverage), Medicare Parts A and B (hospital and medical insurance) and Part C (Medicare Advantage).  This information can be an important factor with COBRA analysis.

You can download the file to view these details with the button below or view them in the PDF file viewer at the bottom of this post.

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