COBRA ????

[Guest robin]

My husband recently left a company and received his COBRA papers. The notification listed the option of taking medical, dental, and RX all together. His new job doesn't offer dental for 1 year, so I called to see if they would offer only the dental COBRA and they said that it was all one plan and couldn't be separated.

The problem is that it isn't one plan. The medical is an HMO and the Dental is through another carrier. Is this legal since they are two separate plans? I have always been under the impression that you must offer the COBRA for each plan seperately.

Any help you can give will be appreciated. I really don't want to wait an entire year for coverage. Thanks.

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Robin

[Guest Angie]

I quit my job on 2/24. I was told at exit interview that I would change to Cobra and not to worry about insurance. I went to fill a prescription and was told my insurance was cancelled on 3/1. I didn't receive my papers from employer to change to Cobra until 3/9. I returned them in person and they then sent me more papers to fill out and send to insurance carrier along with payment which I did on 3/17. Since then I have seen 2 doctors and 1 dentist and have had 3 prescriptions filled. Bills are adding up. How soon do they switch you over to Cobra and how quickly are your medical bills reimbursed?

[Larry M]

this is in response to Robin's question concerning dental care coverage.

It is my understanding COBRA splits health care into two categories. The main one is called "core" coverage and includes what most of us consider to be medical benefits.

Then the other kinds of benefits are given the name "non-core" coverage, which includes vison and dental care.

COBRA requires the employer to provide the same core coverage plus any non-core coverage to a person eligible for COBRA. In effect, this is one "plan" even though the benefits may be provided by different carries.

COBRA also allows the employer to NOT provide the non-core coverages (dental or vision) as separate "stand alone" benefits available under COBRA.

In your case, the employer is within its rights to allow you to choose either the core medical plan alone or the core medical plan plus the non-core dental as a package.

[i am not an attorney and these are my lay opinions.]

Now, a question for you - is the dental coverage really an economically sound benefit for you to buy? By paying all the premium yourself, you may end up spending more money than if you took care of the dentist's bills directly.

[KIP KRAUS]

This is to Robin. I agree with larry M with regard to the employer not being required to split up dentla and medical provided the emplopyer requires active employees to be enrolled in both coverage and does not allow them to take dental only. This by the way is not uncommon. The other point Larry M. makes is the economics of paying the dental COBRA premiums if the premiums outway the projected cost of your dental care.

[KIP KRAUS]

This is for Angie. Depending on who the insurer is it could take them as long as two weeks from receipt of your COBRA application to get you into their claims system. Even new employee enrollments can take this long. If I were you I'd call the insurer's claims office and ask them when they would expect to have you in their system. In any event, once you are your coverage will be retroactive to March 1and any medical expenses incurred since then should be processed by them. They should be able to give you the best information.

Good Luck.