Medical Condition discovered during last month of Cobra coverage

[Guest K Hannon]

A relative of mine has been on COBRA coverage since she left her job to care for her mother. Her last month (18th) month of coverage was May, 1999. During that month, she went for a physical and cancer was disovered. She underwent surgery and had a radical mastectomy. The surgery was performed in May. She will obviously need more medical attention / follow-up and possibly some radiation. Is there any way for her to extend her COBRA coverage - what options does she have at this point?

[Guest jamesfdavis]

If the plan has a conversion option, exercise it now. Also look into extending COBRA through 29 months as a disabled QB.

[This message has been edited by jamesfdavis (edited 06-06-99).]

[KIP KRAUS]

K:

Unfortunately,according to my understanding of COBRA legislation your mother would not be eligible for the disability extension unless she can prove that she was disabled prior to her COBRA event or with the first 60 days of COBRA continuation coverage.

I agree with James, however that she should look into a converted policy if offered. She may also have what is sometimes called "extended medical coverage' for a particular health condition following termination of group coverage. If this provision is in her group coverage it would only cover expenses related to her current medical condition. Check with the former employer and/or the insurer.

Good luck

[Guest Pamela Gaume]

Purchasing a HIPAA-qualified individual policy or HMO would be preferable to the conversion plan--at least under Calif conversion benefit rules and premiums. Under HIPAA rules she would have 63 days following the end of COBRA to make application to any carrier/HMO that is marketing an individual product to the general public. The plans and premiums would be more favorable than the CA conversion option and the carrier/HMO cannot refuse to accpet her nor apply pre-existing condition waiting periods.

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[Guest friedbrain]

You should also determine whether there are any state laws providing continuation coverage beyond Federal COBRA. For example, despite preemption concerns, I've heard that most CA insurers abide by the CA extended continuation coverage law which for certain individuals (i.e., those who have been employed for at least 5 years w/employer prior to term and were at least 60 years of age upon term.) gives them coverage up to age 65.