Between Fellowship/Residency and First Job: Cobra or Buy Health Insurance?

[bulldog]

I'm finishing up fellowship and will be joining a group that doesn't have group insurance benefits and I will have to get my own health insurance. I'd probably just get health insurance and pay out of pocket for dental and vision.

Will take 1-2 months between end of fellowship and starting new job. Should I get my own insurance policy for July 1st, or Cobra until I start the new job? Any recs? Any suggestions for insurance policies to get? So new to all of this.

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[gutonc]

I'm finishing up fellowship and will be joining a group that doesn't have group insurance benefits and I will have to get my own health insurance. I'd probably just get health insurance and pay out of pocket for dental and vision.

Will take 1-2 months between end of fellowship and starting new job. Should I get my own insurance policy for July 1st, or Cobra until I start the new job? Any recs? Any suggestions for insurance policies to get? So new to all of this.

COBRA is a good idea if you can swing the money. The upside of COBRA is that you have 60 days after leaving your position to sign up for it so you might not even have to pony up any money if you don't need it.

You could also go for a high deductible catastrophic plan which will be cheaper (assuming you don't need routine medical care).

 

[Boondahgle]

Quick question: Was reading up a bit on the whole Cobra thing...seems like kind of a pain if you do end up having to make a retroactive claim even though you have around 60 days to decided if you want to continue coverage with Cobra. I'm thinking I may just elect to do a BCBS high deductible plan (my state has one with $5000 deductible) that around$220/month. Cobra was quoting ~$850 /month plan which seemed ridiculous. What do you guys think? My coverage thru my employer ends July 31st and I can get BCBS coverage effective August 1st. My job begins Oct 1st. Seems like the easiest thing to do for now while still get coverage for major issues. I don't need any routine/regular medical care fortunately at this point.

 

[NotAProgDirector]

It is up to you. Although COBRA is more expensive on paper, if you don't have any claims it will be cheaper (in fact, it will be free). Given that, I'd stick with the COBRA. If you actually need coverage, then the hassle of the paperwork will be the least of your problems.

 

[Shikima]

How long does COBRA last for?

 

[ThoracicGuy]

How long does COBRA last for?

Generally you have 60 days to decide to use it or not from the time your policy ends. My fellowship ended on June 30th, but I got a paycheck in mid July. Because of that, I actually had coverage until the end of July. Thus Cobra could have been in effect from August 1 through Sept 30th.

 

[Shikima]

Generally you have 60 days to decide to use it or not from the time your policy ends. My fellowship ended on June 30th, but I got a paycheck in mid July. Because of that, I actually had coverage until the end of July. Thus Cobra could have been in effect from August 1 through Sept 30th.

This is good to know that I have 60 days to sign up for it. How long will it be active for - is there a set period of time or can it last lifetime?

 

[drcrispmd]

Blue cross has short term policies that are much cheaper than cobra. My cobra coverage was going to be $377 per month (I have no medical conditions and went the the doc once through residency). The blue cross which has much lower deductible was $130 for the 2 months I needed it.

 

[ThoracicGuy]

This is good to know that I have 60 days to sign up for it. How long will it be active for - is there a set period of time or can it last lifetime?

I'm not sure how long you can keep it as I never had to, but I think if you keep paying the payments you can keep it. The 60 days is retroactive as well.

 

[ThoracicGuy]

Blue cross has short term policies that are much cheaper than cobra. My cobra coverage was going to be $377 per month (I have no medical conditions and went the the doc once through residency). The blue cross which has much lower deductible was $130 for the 2 months I needed it.

If you only need it 2 months, do the Cobra without paying for it and if you need it, well then you can pay and get it applied. If you don't use it, as chances are you won't, then you're getting away with it for free.

 

[gutonc]

If you only need it 2 months, do the Cobra without paying for it and if you need it, well then you can pay and get it applied. If you don't use it, as chances are you won't, then you're getting away with it for free.

What he said.

Assuming you have no medical needs and your time frame for new coverage is within the 60 day window, just go bare and COBRA up PRN.

 

[E92er]

Just FYI, it's 45 days, not 60. I have my COBRA papers sitting on my desk. My new job starts in a couple weeks and overlaps with the 45 days so Im not going to elect coverage just yet but in-case something happens, it's there to save my butt...

 

[rokshana]

18 months is how long you can keep COBRA

 

[SoCuteMD]

Just FYI, it's 45 days, not 60. I have my COBRA papers sitting on my desk. My new job starts in a couple weeks and overlaps with the 45 days so Im not going to elect coverage just yet but in-case something happens, it's there to save my butt...

Then whoever is providing your COBRA is in violation of the law, which states you must have a minimum of 60 days. Have my previous job's COBRA paperwork right here and my new job's notification of eligibility for COBRA which both state the same.

 

[dpmd]

The important point is that the OP says his new job doesn't have medical insurance so it isn't like he needs to bridge a time until new benefits start (which is what COBRA is really meant for). I mean he can wait to get new insurance just to take advantage of the fact he can get retroactive COBRA coverage if he wants, but he can just go ahead and shop for whatever kind of coverage he is going to want for the future.

 

[Twptophan]

Seems like you have up to 60 days to elect COBRA coverage but you may have to make a payment as early as 45 days if you elect COBRA. Am I interpreting this correctly?

Accessed 1/2017:
https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna.html
Q14: How do I elect COBRA?
Qualified beneficiaries must notify the plan administer of their election according to the instructions laid out in the election notice. Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage. This period is measured from the later of the date of the qualifying event or the date the COBRA election notice is provided. COBRA coverage is retroactive if elected and paid for by the qualified beneficiary.
Q16: How long do I have before I have to submit my first COBRA payment?
A group health plan cannot require payment for any period of COBRA continuation coverage earlier than 45 days after the day on which the qualified beneficiary made the initial election for continuation coverage.

 

[sazerac]

Looks like you have (at least) 60 days to Elect for coverage, and then another (at least) 45 days after that to pay for it. The 45 day clock starts upon Election.

 

[Waraba]

My understanding is that COBRA is just your (previous employer's) plan continued, but you do not get the employer's subsidized rates. So you have to pay more for the same benefits you were receiving. The payments and claims should follow the same process as before, so I'm not sure I understand aPD's comments above. One issue to consider is that you can stay on COBRA for up to 18 months. In California, after the 18 months, you can apply for Cal COBRA for another 18 months. Cal COBRA costs a bit more yet. Anyway, after that you are on your own...

 

[dpmd]

My understanding is that COBRA is just your (previous employer's) plan continued, but you do not get the employer's subsidized rates. So you have to pay more for the same benefits you were receiving. The payments and claims should follow the same process as before, so I'm not sure I understand aPD's comments above. One issue to consider is that you can stay on COBRA for up to 18 months. In California, after the 18 months, you can apply for Cal COBRA for another 18 months. Cal COBRA costs a bit more yet. Anyway, after that you are on your own...

He means that if you don't reject COBRA but stay unconvered by another plan with the plan to get retroactive coverage if you need it then you can technically have free health coverage for a time period as long as you don't end up needing it.

 

[shopsteward]

If you are going to rely on the strategy of relying on COBRA but not making the election until you need it then it's a good idea to have all your ducks lined up ready, just in case something catastrophic happens -
1. Have all the paperwork signed and ready to go, and

2. Have someone reliable ready who will know if something goes wrong and who will be able to post the paperwork off for you in case you can't.

If that sounds difficult or uncertain, just pay up for the two months either through COBRA or the new insurance: for a few hundred it's not worth the risk of being uninsured.