Understanding Medicare typically isn’t a hot bucket list item, and for good reason – it’s complex, lengthy and dry. Trying to make sense of Medicare laws can be overwhelming for both individuals and businesses. When an employee or dependent is enrolled in a group plan and Medicare, the rules for who is responsible to cover that individual’s medical bills first can be confusing. We’ve laid out a few scenarios to make it a little easier to understand when the employer’s group plan is responsible for paying first and when Medicare takes on the role of primary payor.
COBRA provides temporary continuation of health benefits at group rates for qualifying individuals and their dependents if coverage is lost based on a specific qualifying event. If you qualify for Medicare coverage based on age and are also eligible for COBRA, whether you can have both COBRA and Medicare coverage will depend on which coverage you have first.
There are five different Medicare enrollment periods that allow you to enroll in the various parts of coverage each year. It can feel confusing to understand and keep track of all of them, especially if Medicare is new to you. You can only enroll during certain dates each year, so it is important to be aware of all of the different enrollment periods to ensure you don't miss one.
COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1985, gives individuals the right to continue group healthcare coverage after they have lost it due to certain qualifying events like job loss or reduction in work hours, divorce, death, or becoming qualified for Medicare.