What does COBRA not cover?
Asked by: Adam Legros | Last update: August 21, 2025Score: 4.9/5 (31 votes)
What is not covered under COBRA?
Life insurance is not considered 'medical care,' nor are disability benefits; and COBRA does not cover plans that provide only life insurance or disability benefits."
What are the disadvantages of COBRA coverage?
- COBRA can be expensive, especially compared to the premiums you were paying before your qualifying event. ...
- COBRA does not apply to all employer-sponsored health plans—in particular, those organizations with fewer than 20 employees may have no requirements. ...
- Even if you get an extension, COBRA is only temporary.
What is the COBRA loophole?
If you decide to enroll in COBRA health insurance, your coverage will be retroactive, meaning it will apply to any medical bills incurred during the 60-day decision period. This loophole can save you money by avoiding premium payments unless you actually need care during this time.
Under what circumstances can a COBRA be denied?
If the former employee is considered an eligible plan participant, then he or she would be a qualified beneficiary and entitled to COBRA coverage unless the second exception (denial based on gross misconduct) is applied. Under COBRA, a person who has been terminated for gross misconduct may be denied COBRA.
What Is COBRA for Health Insurance
What is not a COBRA qualifying event?
Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA.
What is the limitation for COBRA?
You can collect COBRA benefits for up to 18 months. This may be extended to 36 months under certain circumstances. If your employer has 20 or more employees, it must follow COBRA rules. COBRA coverage follows a "qualifying event".
How much does COBRA typically cost per month?
COBRA coverage is not cheap.
A COBRA premium can cost on average $400 to $700 a month per person.
What is the 105 day COBRA loophole?
So, if you maxed out the 60 day election period plus the 45 day payment period, you could actually go 105 days without paying for the coverage.
Does insurance end the day you quit?
When you leave or are let go from a job, your health insurance either expires on your last day of work or at the end of the month of your exit, says Andy Gillin, attorney and managing partner at GJEL Accident Attorneys. For example, if you quit on July 15th, your coverage usually continues until July 31st.
What is the largest disadvantage of COBRA?
The primary concern with COBRA is the cost. Paying the full premium can be a significant financial burden, especially during a period of job loss. Here are some potential drawbacks to consider: High Cost: COBRA premiums can be expensive, particularly if you have a family plan.
Is COBRA even worth it?
While it may seem like a lot of money, COBRA may actually cost you less than what you'll pay on the open market. That's because you may still get your former company's group discount. You can also use a health savings account (HSA) to pay for your COBRA premiums. They're considered a qualified medical expense.
What benefits must be covered under COBRA?
Inpatient and outpatient hospital care, • Physician care, • Surgery and other major medical benefits, • Prescription drugs, and • Dental and vision care. COBRA requires most of these plans to provide a temporary continuation of health coverage that would otherwise end due to certain events.
What are the 7 COBRA qualifying events?
The seven COBRA qualifying events that allow individuals to maintain their employer-sponsored health insurance include termination of employment for reasons other than gross misconduct, reduction in the number of work hours, divorce or legal separation from the covered employee, the covered employee becoming entitled ...
Can I use COBRA for dental only?
For example, if you were covered under the medical and dental components on the day before your qualifying event, you may elect continuation coverage for medical only, dental only, or both.
Who pays for COBRA after termination?
(California passed a similar law known as “Cal-COBRA.”) Under COBRA, the group plan health insurance plan made available to terminated workers provides the exact same benefits as they would receive if they were still a member of the group, except that the employees have to pay the employer's cost of providing the ...
What is the 14 day rule for COBRA?
14-Day Notice Period
The HR office must provide the COBRA Election Notice and Election Form to qualified beneficiaries within 14 days from the date of the qualifying event or loss of coverage, or when the HR office is notified, whichever comes first.
What is the loophole for COBRA coverage?
Understanding the 60-Day Loophole
It's not so much of a loophole, but two 60-day windows of time to remember. You have a 60-day window following the end of your employer-sponsored plan to select COBRA coverage or choose a new plan in the individual ACA marketplace.
Does COBRA cover surgery?
If there is coverage for your surgery on your previous employer's health plan, it will be covered under COBRA continuation.
Is COBRA cheaper than marketplace?
Both COBRA and ACA Marketplace plans have their advantages. COBRA lets you keep your exact employer-based plan but is often more expensive. ACA plans may be more affordable, especially with subsidies, but require choosing a new plan. The best choice depends on your financial situation and healthcare needs.
Does COBRA coverage begin immediately?
Assuming one pays all required premiums, COBRA coverage starts on the date of the qualifying event, and the length of the period of COBRA coverage will depend on the type of qualifying event which caused the qualified beneficiary to lose group health plan coverage.
How do I find out how much COBRA will cost me?
Two Ways To Determine Your Cost
Determining your COBRA insurance cost can be done in two ways: using our COBRA Premium Cost Calculator or referencing your W-2 form. Both methods give an accurate estimate of your monthly premium, including any potential administrative fees.
What disqualifies you from COBRA?
Why would an employee not qualify to enroll in Cal-COBRA? The employee is enrolled in or eligible for Medicare. The employee does not enroll within 60 days of receiving the notice of eligibility from the employer. The employee is covered by another health plan.
Why is COBRA so expensive?
Why is COBRA more expensive than employer-sponsored insurance? COBRA is more expensive because the individual is responsible for the entire premium amount without the employer's financial contribution that is provided during active employment.
Are COBRA payments tax deductible?
Are my COBRA premiums deductible? Yes they are tax deductible as a medical expense. There isn't necessarily a “COBRA Tax Deduction”. You can only deduct the amount of COBRA medical expenses on your federal income tax in excess of 7.5% of your Adjusted Gross Income and then only if you itemize deductions.