Is COBRA considered creditable coverage for Part D?

Asked by: Prof. Giovani Doyle  |  Last update: February 11, 2022
Score: 4.4/5 (45 votes)

Typically, COBRA is not creditable drug coverage for Part D. However, if your plan is an exception, you'll have a Special Enrollment Period to join a Part D plan without a penalty. ... If you have COBRA when coverage ends, you won't qualify for a Special Enrollment Period through Medicare.

Is COBRA creditable drug coverage for Medicare?

COBRA is not normally considered to be creditable coverage for Medicare major medical benefits, so people who are enrolled in COBRA and do not enroll in Medicare Part B within 8 months of turning 65 face substantial financial penalties for the rest of their lives, even if they have months or years left on their COBRA ...

Do I need Medicare Part D if I have COBRA?

Additionally, you may need to get Medicare Part D – whether you take COBRA or not. ... If you take COBRA and it does provide creditable coverage, then yes, you may be able to delay Part D without penalty. In this case, you will have 63 days after losing COBRA coverage to enroll in Part D without penalty.

What is creditable coverage for Part D?

Under §423.56(a) of the final regulation, coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard prescription drug coverage under Medicare Part D, as demonstrated through the use of generally accepted actuarial principles and in accordance with CMS actuarial ...

Can you use COBRA as a supplement to Medicare?

If your Medicare benefits (Part A or Part B) become effective on or before the day you elect COBRA coverage, you can continue COBRA coverage as well as having Medicare. ... If you become entitled to Medicare after you've signed up for COBRA, your COBRA benefits cease.

Everything you need to know about COBRA

36 related questions found

Is COBRA considered a group health plan?

COBRA coverage is not considered a group health plan based upon current employment. So, if an employee becomes eligible for Medicare but elects not to enroll at that time, believing he or she will enroll in COBRA instead, there are no future “special enrollment rights” for Medicare.

Can you have COBRA and another insurance at the same time?

You may not have COBRA continuation and another insurance at the same time. ... You may stay on COBRA as long as you do not obtain other insurance or become covered under your new employer's health insurance. The federal government's COBRA law allows workers to continue on the same plan they had when they working.

What is not considered creditable coverage?

“Creditable coverage” means that the prescription drug coverage provided by the group health plan provides benefits that are at least equal to or better than Medicare Part D. “Non-creditable coverage” means that the group health plan's benefits are less than Medicare prescription drug coverage.

Which of the following is not a condition for drugs covered under Part D?

Drugs not covered under Medicare Part D

Weight loss or weight gain drugs. Drugs for cosmetic purposes or hair growth. Fertility drugs. Drugs for sexual or erectile dysfunction.

How do I know if my coverage is creditable?

A group health plan's prescription drug coverage is considered creditable if its actuarial value equals or exceeds the actuarial value of standard Medicare Part D prescription drug coverage. Prescription drug coverage that does not meet this standard is called “non-creditable.”

Can you be on COBRA after 65?

Medicare Part A & B is insurance that is available to those 65 or older and those younger than 65 on Social Security Disability. ... You may be on COBRA after your employment ends, but once you are eligible for Medicare, you should enroll in Medicare A & B.

Is COBRA considered employer coverage?

COBRA-covered group health plans that are sponsored by private-sector employers are generally considered welfare plans under ERISA and therefore subject to ERISA's other requirements. ... One option may be “special enrollment” in other group health coverage.

Who is not eligible for COBRA coverage?

The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations.

What medications are covered by Medicare Part D?

Medicare Part D plans must cover all or substantially all drugs in six categories: antidepressants, antipsychotics, anticonvulsants, antiretrovirals (AIDS treatment), immunosuppressants and anticancer.

What type of insurance is Medicare Part D quizlet?

Medicare Part D help cover the cost of prescription drugs, is run by medicare approved insurance companies, may help lower prescription drug costs, and may protect against higher costs in the future.

Who is eligible for Part D coverage?

Those 65 or older who are entitled to or already enrolled in Medicare are eligible for Part D drug insurance. Also eligible are people who have received Social Security Disability Insurance (SSDI) benefits for more than 24 months and those who have been diagnosed with end-stage renal disease.

Do all Part D plans cover the same drugs?

All plans must cover a wide range of prescription drugs that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer or HIV/AIDS. A plan's list of covered drugs is called a “formulary,” and each plan has its own formulary.

What condition must be met for Medicare Part D to pay for a medication?

You must be enrolled in Medicare Part A and/or Part B to enroll in Part D. Medicare drug coverage is only available through private plans. If you have Medicare Part A and/or Part B and you do not have other drug coverage (creditable coverage), you should enroll in a Part D plan.

What counts as creditable coverage?

Creditable coverage is a health insurance, prescription drug, or other health benefit plan that meets a minimum set of qualifications. Types of creditable coverage plans include group and individual health plans, and student health plans, as well as a variety of government-sponsored or government-provided plans.

Which of the following are creditable coverage?

Health insurance coverage under any of the following: a group health plan; individual health insurance; student health insurance; Medicare; Medicaid; CHAMPUS and TRICARE; the Federal Employees Health Benefits Program; Indian Health Service; the Peace Corps; Public Health Plan (any plan established or maintained by a ...

Does creditable coverage apply to Part B?

If you have health insurance through a large employer, it will qualify as creditable coverage for Medicare Part A and Part B, provided it covers as much as or more than original Medicare.

Is COBRA extended due to Covid?

Soon after the COVID-19 pandemic shut down the nation, the federal government extended the deadlines for electing COBRA and paying COBRA premiums for continuation of health insurance coverage. ... The first COBRA premium is due 45 days after the initial election is made.

Can I add my spouse to my Cobra insurance?

Is it possible to add a new spouse or dependent to my COBRA coverage? Yes. A qualified insurance beneficiary has the same rights to add newly acquired dependents on the group health plan, just like if they were employed.

Are COBRA payments tax deductible?

Premiums for COBRA insurance are tax deductible, as they are paid entirely by you on an after-tax basis. If you buy medical coverage through an insurance marketplace, then premiums would be tax deductible as a medical expense.

What type of insurance is COBRA?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a health insurance program that allows eligible employees and their dependents the continued benefits of health insurance coverage when an employee loses their job or experiences a reduction of work hours.