COBRA across state lines
July 24, 2006 8:57 AM   Subscribe

COBRAFilter: I'm quitting Thursday and moving out of state. Can I still use COBRA?

COBRA allows you to keep your health plan(s) - but - most insurance is in a specific state. I.e. when I move to Texas from Arizona, can I still get COBRA that works in Texas or am I SOL?

My company currently resides in FL and I work in AZ as a contractor for a client so I know that they had to find difference insurance for me in AZ than the FL people.
posted by jimmy0x52 to Health & Fitness (10 answers total)
Call your plan administrator. I have had COBRA and have gotten coverage outside the area. That was some years ago, and plans may vary. For a definate answer, contact your plan administrator.
posted by 6:1 at 9:09 AM on July 24, 2006

Best answer: You'll have the same benefits - and limitations - under COBRA as you've had as an employee. If your current plan treats providers in other states as "out of network", they will be still be out of network under COBRA.

Here's an article that goes into more detail and offers some good COBRA advice.
posted by Snerd at 9:13 AM on July 24, 2006

Best answer: It depends on what type of health network you're enrolled in through COBRA. An HMO may only cover you in a specific plan area, whereas a PPO may cover you nationwide. Only your plan administrator can tell you.
posted by scody at 9:29 AM on July 24, 2006

Talk to your plan administrator. You're supposed to be treated like a similarly situated active employee. Most health plans have provisions for out-of-state people (usually salespeople or dependents in college, but it will probably work for you).
posted by ZippityBOP at 9:48 AM on July 24, 2006

Response by poster: Looks like i'm out of network - which blows - if I keep this COBRA.

Looks like I'll just get some high deductible coverage until the new health plan at the new job takes effect.
posted by jimmy0x52 at 11:10 AM on July 24, 2006

Looks like I'll just get some high deductible coverage until the new health plan at the new job takes effect.

If you're sure of a new health plan at a certain date, you may be able to get by with a "wait and see" approach to COBRA, as described in the linked article.

Another consideration is whether the new health plan has a waiting period for pre-existing conditions. Continuous coverage, including COBRA coverage, can eliminate exclusions for pre-existing problems as a source of uninsured expense. From the article:

Under the Health Insurance Portability and Accountability Act of 1996, or HIPAA, group insurance plans may only exclude your pre-existing conditions for up to 12 months -- 18 if you're a late enrollee -- minus your period of prior coverage. (A "late enrollee" is someone who doesn't enroll when he or she is first eligible to do so, except for those people who enroll through a special enrollment opportunity due to marriage, birth of a child, adoption of a child or certain other limited circumstances recognized by regulations.)

In other words, if you were covered under your old insurance plan for more than a year, you could get coverage immediately. However, if you go without insurance for 63 days or more, your new job could start the clock again, making you wait another year before you're eligible. And that can be a very expensive year for you.

Keep in mind that non-local COBRA coverage may not be of much help with minor medical problems, but you could still travel back to AZ for care if something serious comes up. Your plan administrator can explain what emergency coverage is available in TX.

Crazy system, huh?!
posted by Snerd at 12:21 PM on July 24, 2006

Response by poster: Only pre-existing condition is high blood pressure - which I'm taking a pill for that costs ~$7 a month - and I've got enough refills left to get me to my employee plan.

In addition - my current doctor I've been with for over 10 years and has been more than willing in the past to call in antibiotics, etc. for me should I call him and need them without requiring an office visit.

Also called the Target pharm in TX to confirm that there are indeed NO laws preventing my doctor from calling in such prescriptions. The only restrictions are heavy-duty pain killers you MUST have a paper prescrip for. Luckily in those cases I'd A) most likely be covered by this health plan I'm gonna take out in the short-term because I'd likely be at the emergency room or B) I have family in AZ still who could pick up the prescrip and overnight it to me.
posted by jimmy0x52 at 1:53 PM on July 24, 2006

Response by poster: Additional question if anyone gets down this far: Anyone else have a UnitedHealth Saver 80 high deductible plan?

And goods/bads?

I know how it works - 2.5k deductible then 20% up to a maximum where they'll pay the rest. Still better than paying for your own organ transplant, IMHO, but this is more of a 'don't make me bankrupt' emergency plan for my wife and I (getting the maternity rider too - y'know, just in case :)
posted by jimmy0x52 at 1:55 PM on July 24, 2006

Only pre-existing condition is high blood pressure - which I'm taking a pill for that costs ~$7 a month

Don't think that always matters. Kaiser Permanente refused me based on the by-then-generic prozac.
posted by phearlez at 3:28 PM on July 24, 2006

Just as an FYI, the COBRA coverage is limited to what the employer has availible to the member at the time they enroll. If circumstances change, there is no provision to make exceptions. Moving, disability, marriage, etc would not be automatic items which would change the COBRA coverage. Some plans may have alternate options (A PPO plan for example) which they will allow you to switch to when COBRA is elected.
posted by slavlin at 12:12 PM on August 22, 2006

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