COBRA + prescription out-of-pocket info.

Thought I would start a new thread about this, in case anyone had further questions. COBRA can be quite confusing, especially during the transitional period of waiting for it to kick in. What if you need to go to the doctor? What if you need medications? Do you have to pay full-price, & just eat the cost?

- COBRA is something which does not just kick in automatically- you must elect it first.

1-- The U.S. Dept. of Labor grants employers (a total of) 44 days to get COBRA documents into the hands of COBRA-eligible individuals.

2-- When you receive the documents, you then have 60 days to decide whether or not to elect COBRA coverage.

3-- If you decide to elect coverage, you have 45 days to make your initial premium payment, at which time, your COBRA becomes active.

You might have noticed that your employer sent these docs out to you quickly. That was helpful, wasn't it? This helps to foster a seamless transitional process for your health benefits- so you avoid the headache of having to pay for ins. co-payments &/or full-price for prescriptions out of pocket while waiting for your COBRA to become active. But, unfortunately your employer isn't required to do this (and some of them take their sweet time). It's just a measure of courtesy if they send out the docs soon after you become eligible.

When you are expecting the docs from the employer/plan admin. & have not received them (& it's still w/in the 44-days), you may still need to visit the doctor/dentist/pharmacy.

And you may do so. You just need to be sure to keep all receipts & send them in to your ins. company w/ completed claim forms (obtained from your ins. company). Tip: Tell the pharmacist your situation, and they may add a med spec sheet or some add'l info to your receipt.

When COBRA becomes active, you'll be reimbursed for the qualified out of pocket costs (i.e. certain scripts/preventive dental exams), that your plan should have covered, but that you had to paid for (minus co-pays, etc).

Hope this makes sense. COBRA can really be a nightmare *especially* for those who have monthly scripts &/or doctor visits; and, *especially* when employers have all that time to get the docs sent out.

If anyone has questions, please let me know. Human resources mgmt is my career, and I love topics like this. I'm the HR Guru, after all! ;)

Dx: BPII w/rapid cycling, ADHD, OCD, specific phobia *all controlled*; substance addiction *full recovery >1year*

Rx: Topamax, Adderall, WellbutrinSR, Omega3 [Klonopin & Lunesta as needed]

COBRA + prescription out-of-pocket info.

Thread

Post a new follow-up

Notify the administrators

Start a new thread