Previous Thread
Next Thread
Print Thread
#114776 03-30-2010 06:22 PM
Joined: Jun 2007
Posts: 718
mhupe Offline OP
"Above & Beyond" Member (500+ posts)
OP Offline
"Above & Beyond" Member (500+ posts)

Joined: Jun 2007
Posts: 718
I carry the insurance for our family and have decided to switch jobs and take a few weeks off in between. As a result of the timing and eligibility for the new plan, we will have a period of a month and 1/2 w/out coverage. Do I need to buy COBRA to ensure Dan has uninterupted coverage. Or, is it ok to have a month 1/2 lapse? Does anyone know if this is a federal or state-by-state question?

I appreciate any help you can provide!


Margaret
----------
C/G: Husband, 48 (at time of dx)
Dx 5/18/07 SCC, BOT, lymph node involvement. T1N2BM0. (Stage 4a, G2/3)
Tx 6/18 - 8/3/07, IMRT x 33 Cisplatin x3 (stopped after 1st dose due to hearing issues). Weekly Erbitux started 6/27/07 completed 8/6/07.
mhupe #114778 03-30-2010 06:42 PM
Joined: Sep 2009
Posts: 618
"Above & Beyond" Member (500+ posts)
Offline
"Above & Beyond" Member (500+ posts)

Joined: Sep 2009
Posts: 618
The number is different for different states but I think 6 weeks is right at the federal limit that is allowable maximum. I had this same problem. I would buy the COBRA to be absolutely sure as these insurance companies can come up with some real hum dingers. Some states allow insurance to declare a preexisting condition on the transfer after only a few weeks of non-coverage.

I would definitely check with your state insurance commissioner or a good independent agent before going uncovered.


Kelly
Male
48, SCC (Soft Palet) Rt.,
Stage 1, T3n0m0,
Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09
04-20-10 NED
8-11 recurrence, node rt. neck N2b
10-11 33 IMRT w/chemo wkly
3-12-12 PET - residual cancer
4-12 5 treatments with Cyberknife & Erbitux
6-19-12 Pet scan CLEAR
12-3-12 PET - CLEAR
mhupe #114780 03-30-2010 07:10 PM
Joined: May 2006
Posts: 720
Likes: 1
"Above & Beyond" Member (500+ posts)
Offline
"Above & Beyond" Member (500+ posts)

Joined: May 2006
Posts: 720
Likes: 1
From the U.S. Department of Labor website:

[quote]Is there a limit to the period of time I can go without coverage between jobs if I want to reduce the length of a preexisting condition exclusion?

Yes. The break in coverage between one period of health coverage and another can be no longer than 63 days (just over 2 months). If you are between jobs and do not have health coverage for 63 days or more, then you may lose the ability to use the coverage you had before the break to offset a preexisting condition exclusion period in a new health plan. [/quote]

About COBRA, also from the Labor Department website:
[quote]Q7: How long after a qualifying event do I have to elect COBRA coverage?

Qualified beneficiaries must be given an election period during which each qualified beneficiary may choose whether to elect COBRA coverage. Each qualified beneficiary may independently elect COBRA coverage. A covered employee or the covered employee's spouse may elect COBRA coverage on behalf of all other qualified beneficiaries. A parent or legal guardian may elect on behalf of a minor child. Qualified beneficiaries must be given at least 60 days for the election. This period is measured from the later of the coverage loss date or the date the COBRA election notice is provided by the employer or plan administrator. The election notice must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.[/quote]
Since you have 60 days to elect COBRA once you receive formal notice that it is available, you may just want to wait and see if it is needed.

But I'd check with your state insurance office or some other unbiased (e.g. not trying to see you insurance) authority.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
Joined: May 2006
Posts: 720
Likes: 1
"Above & Beyond" Member (500+ posts)
Offline
"Above & Beyond" Member (500+ posts)

Joined: May 2006
Posts: 720
Likes: 1
Margaret --

Here's a similar document from the Wisconsin insurance commissioner's office. Note that it says the break-in-coverage period is no longer than 62 days.

The state's information on COBRA is here. Note (bottom of p. 3) that it says you have 30 days to decide to get it. (Your former employer has five days to notify you that COBRA is available; you then have to decide to get it within 30 days of that notification.)

I still would check with the insurance commissioner's office to make sure the material is up to date.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
Joined: Sep 2009
Posts: 618
"Above & Beyond" Member (500+ posts)
Offline
"Above & Beyond" Member (500+ posts)

Joined: Sep 2009
Posts: 618
Also,

As I remember, you have to present the COBRA notification letter from your former employer so don't lose it.


Kelly
Male
48, SCC (Soft Palet) Rt.,
Stage 1, T3n0m0,
Dx, 8-09, Start IMRT 35 9-2-09 end 10-21-09
04-20-10 NED
8-11 recurrence, node rt. neck N2b
10-11 33 IMRT w/chemo wkly
3-12-12 PET - residual cancer
4-12 5 treatments with Cyberknife & Erbitux
6-19-12 Pet scan CLEAR
12-3-12 PET - CLEAR
Joined: May 2002
Posts: 2,152
Patient Advocate (old timer, 2000 posts)
Offline
Patient Advocate (old timer, 2000 posts)

Joined: May 2002
Posts: 2,152
Personally, I wouldn't want to take the chance to save a few thousand dollars. If you can afford it, I'd buy it and sleep better.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
Eileen #114862 03-31-2010 05:49 PM
Joined: Jun 2007
Posts: 5,260
Patient Advocate (old timer, 2000 posts)
Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 5,260
maybe the illegals have the right idea/..


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
EzJim #114863 03-31-2010 05:50 PM
Joined: Jun 2007
Posts: 5,260
Patient Advocate (old timer, 2000 posts)
Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 5,260
Maybe I should have used different words.


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here

Link Copied to Clipboard
Top Posters
ChristineB 10,507
davidcpa 8,311
Cheryld 5,260
EzJim 5,260
Brian Hill 4,912
Newest Members
Jina, VintageMel, rahul320, Sean916, Megm37
13,103 Registered Users
Forum Statistics
Forums23
Topics18,167
Posts196,922
Members13,103
Most Online458
Jan 16th, 2020
OCF Awards

Great Nonprofit OCF 2023 Charity Navigator OCF Guidestar Charity OCF

Powered by UBB.threads™ PHP Forum Software 7.7.5