COBRA As A Bridge To Medicare

Is there an exception for an employee beginning COBRA coverage at age 62, giving him 36 months to bridge the period before Medicare begins?

Unfortunately there is no general exception for an employee who begins COBRA coverage at age 62.

You may be thinking of what happens when an employee becomes entitled to Medicare and later has a termination of employment (or reduction in hours). In that case, the COBRA coverage period for the employee’s spouse and dependent children lasts until the later of
(a) the 36-month period beginning when the covered employee became entitled to Medicare; or
(b) the 18-month maximum coverage period beginning when the covered employee terminates employment.

Another possibility is the 11-month disability extension. This extension allows a disabled qualified beneficiary to remain on COBRA for a maximum of 29 months, which is intended to be long enough to qualify for Medicare. An individual with a Social Security disability determination is entitled to Medicare 24 months after beginning to receive monthly disability payments, and there is a five month waiting period before monthly Social Security disability payments begin. For this COBRA extension to apply, the following conditions must be met:

  • the qualifying event must be the covered employee’s termination of employment or reduction of hours;
  • a qualified beneficiary (who may be the covered employee or his or her spouse or dependent child) must be determined under the Social Security Act to have been disabled at any time
  • during the first 60 days of COBRA coverage;
  • the qualified beneficiary must notify the plan administrator of the Social Security disability determination within 60 days after the latest of
    (a) the date of the disability determination;
    (b) the date of the qualifying event;
    (c) the date the qualified beneficiary loses coverage under the plan as a result of the qualifying event; or
    (d) the date the qualified beneficiary is informed, through the furnishing of the plan’s SPD or COBRA initial notice, of both the responsibility to provide the notice of disability determination and the plan’s procedures for providing such notice to the administrator; and
  • the qualified beneficiary must notify the plan administrator of the Social Security disability determination before the end of the 18-month period following the qualifying event.
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