Ask the Health Insurance Expert
QI have health insurance coverage through my husband's employer-sponsored health plan. He is about to retire. I'm not eligible yet for Medicare, and I have been denied individual health insurance because of pre-existing conditions. How can I find coverage once he leaves his job?
When your husband retires, you should be eligible to continue coverage on his health plan through COBRA continuation health coverage. COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a landmark law passed by Congress in 1986 to provide a safety net for employees and their dependents who lose employer-sponsored health insurance coverage because of a job loss or change, divorce or death. Spouses and dependent children are also eligible for the continuation coverage if the covered employee becomes eligible for Medicare.
The COBRA law applies to employers with 20 or more workers, but many states have their own "mini-COBRA" laws that apply to smaller firms as well.
Your husband's employer should notify the health insurance plan administrator within 30 days after he leaves his job. The plan administrator should then send your husband an election notice for COBRA within 14 days. At that point, you have 60 days to decide whether to continue coverage through COBRA. Both of you can select COBRA; or, if your husband is eligible for Medicare, you can get COBRA coverage by yourself.
In most cases, you pay the full premium for COBRA coverage. So if the employer has been footing the bill for health insurance, be prepared to budget for this new expense. After selecting COBRA coverage, you will have 45 days to pay the initial premium.
Generally, you're eligible to receive COBRA continuation coverage for 18 months or 36 months, depending on the circumstances.
Once you've exhausted COBRA coverage, you will be eligible for a guaranteed-issue health plan, also referred to as a HIPAA plan, which can't deny you coverage because of a pre-existing condition. HIPAA refers to another landmark federal law, the Health Insurance Portability and Availability Act. Among other things, HIPPA helps protect people from losing access to health insurance so long as they have not had a "significant break" in their coverage--defined as 63 days or more.
Once you're at that point in the process, contact your state insurance department to find insurance companies that sell guaranteed-issue plans. You can't get insurance quotes for these plans online.
For more, see 10 things you should know about COBRA.