Continuation Coverage for Spouse

[401Karina]

If an employee who his 66 years old and on Medicare retires on Jan. 1, and his spouse is not yet eligible for Medicare wants to carry COBRA, how long can the spouse carry COBRA?

[hr for me]

When the qualifying event is the end of employment or reduction of the employee's hours, and the employee became entitled to Medicare less than 18 months before the qualifying event, COBRA coverage for the employee's spouse and dependents can last until 36 months after the date the employee becomes entitled to Medicare. For example, if a covered employee becomes entitled to Medicare 8 months before the date his/her employment ends (termination of employment is the COBRA qualifying event), COBRA coverage for his/her spouse and children would last 28 months (36 months minus 8 months). For more information on how entitlement to Medicare impacts the length of COBRA coverage, contact the Department of Labor's Employee Benefits Security Administration at askebsa.dol.gov or by calling 1-866-444-3272.

https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf

[Brian Gilmore]

@BSI S125 The spouse can continue coverage through COBRA until the first of the following occurs:

1.  The spouse exhausts the COBRA maximum coverage period (18 months of a termination of employment qualifying event); or
2. The spouse enrolls in Medicare (or another group health plan).

The spouse will want to enroll in Medicare upon becoming eligible to avoid a late enrollment penalty and the potential for the plan (COBRA) to assume Medicare primary coverage.

Full details here: https://www.theabdteam.com/blog/how-cobra-and-medicare-interact-for-retirees/

Note that in some scenarios the COBRA maximum coverage period for a spouse or dependent can extend beyond 18 months if the employee recently enrolled in Medicare prior to terminating employment.  In that situation, the maximum coverage period for the spouse or dependent is the later of:

1. 36 months from the date the employee enrolled in Medicare; or
2. 18 months from the date of termination (or reduction in hours).

Full details on Slide 12 here: ABD Office Hours Webinar: Medicare for Employers.