I am not a Social Security Disability lawyer. Nor am I health law attorney. As such, when I went looking for an answer to a question about extending COBRA I asked my colleages. Unfortunately, in many cases, even lawyers who practiced in the area didn’t know the answer to my questions, so I’m going to share it with you.
The Answer to COBRA Continuation and SSD
If you are on COBRA and found disabled by Social Security within a limited period of time, you may be able to extend your COBRA coverage so you will be insured until you are eligible for Medicare. However, you must meet very specific requirements.
COBRA is a law which requires employers that have over 20 employees and provide health insurance, to allow you to continue that health insurance for a period of 18 months. You have to pay the full monthly cost of the health insurance as well as a small administrative fee.
SSDI and Health Insurance
If you are found eligible for Social Security Disability (SSD or SSDI) you will not receive Medicare until your 30th month of disability. This means you need to find a way to cover your health costs for 29 months from the date you are declared disabled.
You will read that you are eligible for Medicare 24 months after you are eligible to receive SSD payments. When you are declared disabled by Social Security, your first date of payments begins in the 6th month of your disability. So you begin counting your Medicare eligibility from your first month of payments.
There is, an apparently little known law, which allows you to extend COBRA for an additional 11 months if you are found disabled within a limited period of time. The government webpage on this issue states that this “is a complex area of COBRA law” but I can share the basic idea with you.
Essentially, here are the requirements:
- You chose to use COBRA
- You are found to have a disability date that begins within the first 60 days of COBRA coverage.
- You are found disabled within the 18 months of COBRA coverage.
- You timely notify the COBRA administrator.
As an example:
- You leave work due to a disability on March 1, 2017.
- You immediately elect to use COBRA for your health insurance. You timely pay the cost each month.
- You apply for Social Security Disability in June, 2017.
- You are approved for Social Security Disability on March 2, 2018, with a disability date of March 1, 2017.
- You immediately notify your COBRA administrator and send them the paperwork showing your approval and disability onset date.
Under the above, you should generally be approved for COBRA continuation. This means that instead of having your health insurance end in 18 months, you will be able to continue it for 11 months more, or a total of 29 months. You should then be automatically enrolled in Medicare which begins on the 30th month.
The qualifying factors are that you:
- Chose COBRA
- Paid the fees
- Were approved for SSD within the original 18 months
- You had an onset date witihn 60 days of starting COBRA
- Notfied the administrator
Keep in mind, the extra 11 months only lasts as long as you are disabled. If Social Security decides you are no longer disabled during that extra time, you will not be able to remain on the plan and will need to find an alternative health insurance policy.
Why Don’t More Lawyers Know About COBRA Continuation and SSD?
I think the reason few lawyers know about COBRA continuation and SSD is because it is rare for someone to meet the requirements. About 60% of people are denied when they first seek SSD. For people who have successful appeals, it normally takes about two years to receive an approval. As a result, even if the onset date of disability falls within the required time period, the declaration that one is disabled normally falls outside the required 18 months.
Obviously, I cannot guarantee that you will qualify for the extended COBRA time period. Each situation is different. But given so many lawyers are not familiar with the ability to extend COBRA, I did want to share this information. I hope people find it useful. If you have questions, please contact your attorney for help. (I am unable to offer any further information).