April 12, 2017
SSDI & COBRA: Know Your Options
If you become unable to work due to an illness or injury, then applying for Social Security Disability Insurance (SSDI) could benefit you in a variety of ways. One such benefit is the entitlement to Medicare much sooner than the typical age 65, as most SSDI claimants are eligible to enroll in a Medicare plan 24 months after their date of entitlement to Social Security Disability benefits, or, 29 months from their date of disability onset (i.e. Each claimant is required to wait five full calendar months between the date their disability is established and their entitlement to cash benefits. If you are awarded with a disability onset date of 09/05/2015, your entitlement to benefits would be 03/2016 and from there, you could be eligible for Medicare effective 03/2018). While this is certainly exciting news for individuals and families who have been paying medical bills and expenses with what is often insufficient, or no, insurance, this waiting period between receiving an SSDI award and Medicare eligibility can pose significant hardship as it may cause a lapse in health care coverage. Fortunately, when a claimant is awarded SSDI, he/she may also be eligible for an extension on existing COBRA coverage, but many SSDI applicants are unaware that this option may be available to them.
The United States Department of Labor implemented regulations in July 2004 to allow individuals who are receiving group health plan coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to qualify for an 11-month health care coverage extension while waiting for their Medicare entitlement. COBRA coverage, which normally ends after 18 months, can be extended for a total period of 29 months once a claimant is awarded Social Security Disability Insurance.
- In order to be eligible for the extension, the claimant must provide a copy of their Notice of Award or Notice of Decision from the Social Security Administration to their COBRA provider within sixty (60) days of receiving said notice.
- This notice must confirm that the claimant was disabled during the first 60 days of their original COBRA coverage and has remained disabled throughout the full 18-month COBRA period.
- The notice must also be provided to the COBRA administrator before the original 18-months of coverage has lapsed.
- Find more information about COBRA and extending your coverage here!
We encourage all claimants to reach out to their health plan administrator or human resources department at their former employer for any specific questions related to their unique health care coverage and COBRA extension options. When you become eligible for Medicare, be sure to reach out to our resourceful team at Aevo Insurance Services, so a licensed Medicare Specialist can assist you in a finding a plan that is right for you!
This post was written by one of our Benefit Coordinators, Lauryn.