renniemommie 8 Posted March 4, 2011 If I am not approved by Aetena by the time my husband leaves full-time employment within days (which my Dr. thinks Aetna knows is about to happen, hence the wait), do i then have to re-apply thru COBRA? It is supposed to be a continuation of coverage, but is Cobra like it's own insurance company and thus could deny my request for VSG ? Additionally, the Hilton gives NO grace period. The day you leave full-time emp, is the day your bennies end. We can get COBRA, but we can't get COBRA until after he leaves the Hilton and they send us paperwork, so essential a gap in coverage (that is retro-active). So then I guess I'd have to make sure my surgery isn't right around that time, because of the 'gap'. Share this post Link to post Share on other sites
MINI-Me 196 Posted March 4, 2011 COBRA is a continuation of the exact benefits you have today - you just pay the full price of the coverage. You have 56 days to apply/pay and you get back dated to the day coverage ended. To keep "active" vs "COBRA" members accounted for in the systems, you may get a new ID card, but there will be no break in coverage. You should not have to re-submit your paperwork since you have the same benefits, etc. If they tell you that you do, ask for a supervisor immediately! 1 renniemommie reacted to this Share this post Link to post Share on other sites
renniemommie 8 Posted March 4, 2011 COBRA is a continuation of the exact benefits you have today - you just pay the full price of the coverage. You have 56 days to apply/pay and you get back dated to the day coverage ended. To keep "active" vs "COBRA" members accounted for in the systems, you may get a new ID card, but there will be no break in coverage. You should not have to re-submit your paperwork since you have the same benefits, etc. If they tell you that you do, ask for a supervisor immediately! THANKS! That makes sense. So I might not get my surgery on Monday as scheduled (the job cuts your bennies the DAY you leave), but as soon as they send the COBRA paperwork and we pay (for just me), then it is On like Donkey Kong. Ironically, last year I had 100% coverage for this surgery, then they changed the plan and I've had to pay $1,000 hospital and $400 to Dr. plus since my hubby got a new job without WLS coverage, I also have to pay for 2 months Cobra to cover surgery and complications. Irony of ironies. But that is still cheap and about what I thought I'd have to pay before I started anyway. Last night when I was so down and thought I'd missed the timeline I wasn't sure if I was happy or sad, since I am afraid of surgery (dr's done 1000 baratric combined with no deaths), but also dammmm tired of lugging around at least 100 extra pounds, I'm realllly tired of that. Its like I am dragging around a crash cart on my butt all day. LOL and I am not even in medical! Colette! Share this post Link to post Share on other sites
MINI-Me 196 Posted March 4, 2011 Glad that I was able to help out. As far as surgery on Monday ... COBRA is guaranteed & as long as you complete the paperwork and pay in the required timelines, it is back-dated to the day your coverage ended. So, you can go ahead and have the surgery. Just be sure you don't forget to dot any i's or cross any t's on the paperwork! ) Share this post Link to post Share on other sites
renniemommie 8 Posted March 4, 2011 Glad that I was able to help out. As far as surgery on Monday ... COBRA is guaranteed & as long as you complete the paperwork and pay in the required timelines, it is back-dated to the day your coverage ended. So, you can go ahead and have the surgery. Just be sure you don't forget to dot any i's or cross any t's on the paperwork! ) Monday may be off, I am actually STILL waiting on insurance approval. There were more records ordered today from some confusing info in my paperwork. (did I mention the freaking change in bennies, now 20% of everyone and 1k at hospital from 100% coverage last year, so about 2K, 3K after co-pays, diet, psy, sigh...hubby is annoyed I didn't do this sooner!!) ANYWAY, if they don't call me in the next hour, I am going to consider it off for Monday. So, as I understand it, if my hubby loses coverage this Monday thru Hilton (as that is the day he is moving from full-time to either part-time as planned, or putting in 2 week notice, but not coming back in for any days, better for them to let him "keep" insurance those 2 weeks, as we are not on at new job yet either), I can have surgery the next Monday (as how it is looking)? Worry that hospital calls Aetna, who says I'm gone, before I can actually get to Cobra, so all gets postponed, either way, if approved, I'll get in soon, nice job giving me a window in which to work with Aetna! Share this post Link to post Share on other sites
beckyboop74 1 Posted March 9, 2011 I work as an insurance broker so I'm aware of this situation a lot. What insurance carriers are "supposed" to do is to say that your benefits are inactive but you are in your COBRA election period. What I would do is to call the HR person at your husband's company and find out from her what the amount will be for coverage and send in the payment. Let them know that you have a surgery coming up so you can't have a break in coverage, that you don't want to wait for it to come in the mail. Sometimes that helps get the paperwork out even faster. It does depend on the company though. You may want to ask if the company uses a COBRA administrator or if they handle it themselves. If it is through an administrator, you can ask the HR person if you can just pay for one month directly to them to avoid any delays due to paperwork. That is the way I would proceed to keep yourself active. Monday may be off, I am actually STILL waiting on insurance approval. There were more records ordered today from some confusing info in my paperwork. (did I mention the freaking change in bennies, now 20% of everyone and 1k at hospital from 100% coverage last year, so about 2K, 3K after co-pays, diet, psy, sigh...hubby is annoyed I didn't do this sooner!!) ANYWAY, if they don't call me in the next hour, I am going to consider it off for Monday. So, as I understand it, if my hubby loses coverage this Monday thru Hilton (as that is the day he is moving from full-time to either part-time as planned, or putting in 2 week notice, but not coming back in for any days, better for them to let him "keep" insurance those 2 weeks, as we are not on at new job yet either), I can have surgery the next Monday (as how it is looking)? Worry that hospital calls Aetna, who says I'm gone, before I can actually get to Cobra, so all gets postponed, either way, if approved, I'll get in soon, nice job giving me a window in which to work with Aetna! Share this post Link to post Share on other sites