Jump to content
×
Are you looking for the BariatricPal Store? Go now!

COBRA insurance question..losing my Aetna



Recommended Posts

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

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!

Share this post


Link to post
Share on other sites

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

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! :o)

Share this post


Link to post
Share on other sites

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! :o)

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

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

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Ladiva04

      Hello,
      I had my surgery on the 25th of June of this year. Starting off at 117 kilos.😒
      · 1 reply
      1. NeonRaven8919

        Congrats on the surgery!

    • Sandra Austin Tx

      I’m 6 days post op as of today. I had the gastric bypass 
      · 0 replies
      1. This update has no replies.
    • RacMag  »  bhogue925

      Hi, I’m new here. I’m currently on the liver shrinking diet. So far so good, but I have to say I haven’t found a protein shake I like. Anyone have any suggestions please? My surgery date is September 17th. 
      · 2 replies
      1. BlondePatriotInCDA

        Fairlife Core are by far the best. They taste just as they are - chocolate milk. You can either get the 26 grams or the 42 grams (harder to find and more expensive). For straight protein look at Bulksuppliments.com ..they have really good whey proteins and offer auto ship plus they test for purity. No taste or smell...

      2. BlondePatriotInCDA

        Fairlife has strawberry, vanilla and of course chocolate. No more calories than other protein drinks. Stay away from Premiere, they're dealing with lawsuits due to not being honest about protein content.

    • Doctor-Links

      HGH For Sale
      hgh for sale at our online pharmacy
       
      Human growth hormone (HGH) is a small protein which is made in part of the brain called the pituitary gland. It travels in your bloodstream all over your body to make your body grow.
      HGH is very important in the body. It is needed for children to grow normally. It helps make sure there is enough muscle and fat in the body. It keeps our bones healthy.
      Buy Rybelsus online, Rybelsus tablets
      You can order for wegovy at our online pharmacy
      Check for the prices of 0.25mg, 0.5mg and 1mg at our online pharmacy and buy ozempic.
      · 0 replies
      1. This update has no replies.
    • Doctor-Links

      hgh kaufen  in unserer Online-Apotheke  
      Menschliches Wachstumshormon (HGH) ist ein kleines Protein, das in einem Teil des Gehirns, der Hypophyse, produziert wird. Es wandert in Ihrem Blutkreislauf durch Ihren ganzen Körper, um Ihren Körper wachsen zu lassen.
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×