Change to COBRA

Hi!

Just wanted to share a little information with you that hopefully might help. I don't know if the laws differ in Massachusets than where you are but here, any expenses paid out of pocket while you are transitioning to COBRA are reimbursed by the insurance company. You have up to 60 days from the date of termination to sign up for COBRA and any expenses paid out of pocket during those 60 days are reimbursed if you do sign up with COBRA. If you choose not to sign up with COBRA then you don't get reimbursed but seeing as you are signed up with COBRA you should get reimbursed for any expenses you paid out of pocket. In addition, in Massachusetts we have a medical security program for people who are on unemployment. If you are on unemployment and your income falls below a certain amount for 6 months, this program reimburses 80% of your COBRA premiums. This is only available to people on unemployment so you should definitely check with your unemployment office. While the reimbursement doesn't come through them, your unemployment office should have some information on this.

Good luck!

Actually, $900 is pretty realistic for 1 parent-1 child family these days, and ain't that a kick in the head!

They do have to give you the paperwork, but they have 30 days to get everything set up. I know it is incredibly stressful, but these are really pretty responsive time frames.

As KEW said, just, be prepared.

KEW - I was told the same thing you were: that it was an easy process with no disruption of care. Yeah, right. I'm going through the same COBRA nightmare. Was terminated due to disability (used up all of the company LTD) on 6/30/11. They gave me 4 days notice of termination and the actual process states I should have been given 2 months. Due to miscommunication with the company (actually from) I received the COBRA application about 3 weeks later. I mailed them 2 business days after I received them and that was on 7/25. However, I have had 2 appointments - 1 with onc, 2 herceptin infusions, 1 zometa infusion and 1 faslodex in the month of July. When these are processed through the provider, they will be denied due to drop in coverage and I will receive a bill. However, I contacted the provider, informed them of the wait due to COBRA and asked them to rebill. Once on COBRA, the bills should be paid retroactively or one can pay out of pocket, submit the bill for reimbursement from the insurance company. But at close to $6K per appointment, that isn't possible. While I would get lots of points on my credit card, it isn't worth the interest.

So, if you get bills, just contact the billing department to rebill and explain the COBRA issue you have. They may be willing to do that. Don't worry, you will be covered retroactively. A real pain in the a$$. And remember to pay the future COBRA premiums as soon as you can so it doesn't happen again. If the billing department isn't willing to rebill, maybe you could make a small payment out of "good faith" then ask them to rebill the insurance company.

Another big problem as you wrote about, KEW, is prescription coverage. I'm almost out of Tykerb and since the pharmacy has my insurance listed as expired, I have to pay out of pocket. Tykerb is ~$3000+ for a 30 day supply. And I can't get just a few days or a couple of weeks worth. Guess I'll go without for a little while - hopefully it won't hurt. But again, if you pay for your Rx, submit the receipt once COBRA is active and you will be reimbursed. I just hope I have enough painkillers to get me through this time otherwise I'll have no choice but to pay out of pocket.

This is all information I received from my ex-employer and I'm concerned because they have been giving me wrong answers to most of my questions so far. But in further research, the retro-active payments is correct.

Your premiums are extraordinarily high! And unfortunately with a cancer diagnosis finding lower cost coverage is next to impossible. There are options out there but I believe at least one requirement is to be uninsured for 6 months - who can do that? I have similar coverage to you - really great coverage but have to pay 102% of the company's premiums. Just me alone is $412 a month - doubled if I carried my husband (which I did carry all of the insurance). Hopefully your son's father will put him on his plan and you can just split the copays/deductibles - that will reduce your premium considerably. Luckily my DH can get insurance through his employer which is much cheaper than COBRA but he is in construction so he gets laid off quite a bit and will have to go through this mess himself. I'm not going on his insurance because the out-of-pocket expenses are actually more than my COBRA premiums and out of pocket max. And my onc isn't one of their providers, which sucks.

nowords is right - your coverage should be exactly the same as it was - same copays, deductibles, etc. I'm really banking on that. We'll see what next year brings, though.

Good Luck to you. So sorry to be so wordy.

KEW, just to let you know I get my tamoxifen at Walmart, a 30 day supply less then $10.00.