February 13, 2012 12:20 AM   Subscribe

Please help me understand COBRA and my family's options after it runs out.

I left my job in March 2011 and enrolled in COBRA for coverage for myself, my husband and our child. Soon after I left my job, we moved from Oregon to Idaho, a state that our insurance does not cover as part of their network. We rarely visit the doctor so this hasn't been an issue so far, but because our coverage will run out soon (I was recently told it will run out after 15 months, which puts us at June of this year) and it doesn't cover where we live anyway, it made sense to me to try to buy our own insurance plan. Employer-based insurance is not an option right now, as I am not working at the moment and my husband's employer does not offer health insurance.

We applied for an individual policy but were denied because we didn't have a Certificate of Creditable Coverage. I contacted our insurance provider to obtain this certificate and was told, "In order to obtain a Certificate of Creditable Coverage your policy has to be terminated." So now I am mystified how to get off of COBRA if we will be denied from a replacement plan while we still have it.

We are young (26, child is almost 2), very healthy, with no prescriptions. (From what I've heard re: COBRA, our payment seems comparatively low; it has been around $280 and is going up to $310 in a couple weeks.) Being uninsured makes me really nervous and I'd really rather not go that route; at the very least I'd like catastrophic coverage and maternity coverage, just in case.

I understand very little about health insurance and how it all works and what questions to ask to get the answers I need, but I don't want to be left uninsured because of that. Please help me figure out what our options are!

My questions:

1. Do I really need to let COBRA run out (so we can get that certificate) before we can be approved for a different policy?

2. What specifically happens when our COBRA coverage ends? As in, are we considered uninsured until we can be approved for a different policy? Will that affect our eligibility?

3. Because we were denied from the one company we applied to, does that mean we are more likely to get denied if we apply to them again? What about other companies? Does it matter that it was not health-condition-related, but paperwork-related?

4. AskMeFi was the only place I could think of to get help with this. Are there other resources out there for explaining this stuff? I did look here, but it doesn't have answers to several of the things I want to know.

Thanks for any input you have to offer, and please let me know if I've left out any relevant information. (And if I am misunderstanding how COBRA works, please tell me that too! I just don't want to end up uninsured due to a preventable mistake.)
posted by meggan to Health & Fitness (6 answers total)
1. No. You should have a letter that was issued when you switched to COBRA, and you can be issued a letter before COBRA ends. Your former employer can do this too -- I would try there. Also, usually you can substitute a certificate with proof you have been insured if you don't have a letter yet.

2. Yes, you'll be uninsured.

3. SHRM, DOL, a local agent, insurer-specific sites/material, state-specific sites/material.
posted by michaelh at 4:30 AM on February 13, 2012 [1 favorite]

Also keep in mind that if you let COBRA expire and don't get another qualifying policy within about 60 days, you'll lose your protection from pre-existing conditions limitations. I know you think your family is healthy, but never underestimate an insurance companies ability to weasel out of covering a claim. Technically, the insurance company won't give you a Certificate of Coverage while insured, but they should give you a letter stating that you have been covered since whatever date your policy started, which is essentially the same thing and will be sufficient for the new insurance policy. All they want to know is that you have been covered for 18 months, or whatever the applicable time period is in Idaho if different.
posted by COD at 5:27 AM on February 13, 2012 [1 favorite]

I think the agent you spoke with from the insurance company misunderstood your situation. My understanding is that the Certificate of Creditable Coverage is a document that's typically forwarded from one employer to another when you change jobs. Its role is to create a documented statement about the continuity of your coverage.

Since you're wanting to go from employer-provided coverage, extended via COBRA, you need a letter from your current insurance provider documenting how long you've had their insurance. You CAN have two health insurance policies active at the same time, so it's not like you have to have COBRA terminated today and your private plan begun tomorrow. (You probably don't want too much overlap between the two plans, though.)

Note: I'm not an expert in these matters, but I went through something kind of similar, though it didn't involve COBRA in my case.
posted by Philemon at 7:28 AM on February 13, 2012

You should see if you qualify for one of Idaho's public health insurance programs (at least for your child, as the income limit for adult coverage is much lower). Idaho also provides a premium assistance program for qualified residents who purchase private health insurance.
posted by melissasaurus at 8:06 AM on February 13, 2012

1. You can get a letter from your current provider that says you are covered and how long you have been covered.

2. You will be uninsured when COBRA ends unless you have something else in place to start. If you are uninsured for more than 60 days you will have pre-existing condition exclusions so you definitely want to get started before that. It shouldn't affect your eligibility though.

3. It shouldn't affect anything. It shouldn't even affect that one company, you can probably re-apply when you have the proof of coverage.
posted by magnetsphere at 11:46 AM on February 13, 2012

You guys have made me feel so much better - I had no idea there was an alternate letter I could ask for instead of the certificate. Whew! That makes this process a lot less confusing.

I've just sent an email about the letter to my contact at my former employer so we'll see what she says. Thank you for the help!
posted by meggan at 6:30 PM on February 13, 2012

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