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My husband is retired on social security disability and we…

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My husband is retired...

My husband is retired on social security disability and we have to pay $350 a month in COBRA. We were told by COBRA that since he did not get part B medicare after 2 years, they would no longer pay more than 20% of any bill since that was what medicare would pay. We have applied for part B,but he has not received it yet. COBRA is through his employer. He is 60 years old now. my question is, does COBRA have the right to refuse payment on his medical bills like that??

Lawyer's Assistant: These retirement benefits are supposed to help us but they can be so complicated! The Retirement Expert will help you get the most benefits propertly. Is there anything else important you think the Retirement Accountant should know?

He did receive a notice from medicare about part B, but when we talked to social security they told us he didn't need it until he turned 65. We have filed an appeal

Submitted: 7 months ago.Category: Employment Law
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Answered in 12 minutes by:
9/30/2017
Employment Lawyer: emc011075,
 replied 7 months ago
emc011075
Category: Employment Law
Satisfied Customers: 3,707
Verified

Hi. My name is ***** ***** I will be happy to help you.

COBRA stands for Consolidated Omnibus Budget Reconciliation Act, it is a government program, not an insurance company. COBRA guarantees the insurance by the insurance company is a private company. Most employer sponsored insurance plans have a provision that if you are eligible for Medicare, the Medicare becomes primary insurance and the employer sponsored plan becomes secondary. In that case the insurance company is not required to cover anything that Medicare would have covered. If you opt out of Medicare when you are eligible for it, the insurance company does not have to cover 80% of Medicare covered expenses.

You need to check with the insurance company that provides the coverage what the policy is. From what you are describing, it looks like the employer sponsored insurance had the Medicare provision.

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Customer reply replied 7 months ago
they never told us about it. they waited until the 6 months of eligibility were up and then quit paying. when we questioned it, they basically said "too bad"
Employment Lawyer: emc011075,
 replied 7 months ago

It is not insurance company responsibility to make sure you read the policy. If they have your initials or signature on any documents that explains the policy or if your husband signed a receipt that he received the policy brochure, you are considered to be informed. I am going to opt out and request that the category is changed to employment Law, it is really not a tax question.

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