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Find COBRA Insurance information in your state.

Who is Elegible for COBRA?

Who is Elegible for COBRA

Like any law, in order to enroll in COBRA insurance you must meet certain requirements to be eligible. These requirements were created as part of the Consolidated Omnibus Budget Reconciliation Act that was passed in 1986 and are known as qualifying event, qualifying plan, and qualifying beneficiary. To be eligible you must meet all three requirements.

To determine if you are eligible for COBRA you can use the requirements below. You can also ask your Human Resources department or health insurance company and they can tell you if you qualify.

Qualifying Plan

As the covered employee or eligible beneficiary the plan that during employment must meet certain requirements to make you and your family members eligible for coverage. These include:

  • The plan is still active and the company is still in business
  • The plan covered at least 20 full time employees or their part time equivalents

If you worked at a company with between 2-19 employees there may be additional Mini plans available in your state.

Qualifying Event

The second requirement you must meet to be eligible for COBRA is qualifying event, which basically means how the covered employee or beneficiary lost their health insurance. For the covered employee and their beneficiaries, numerous events can qualify including:

  • Being laid off, let go, or fired from the place of employment without gross misconduct
  • Quitting their job
  • Retiring from their job
  • Reduction in hours that disqualifies them from health insurance

Additionally there are other qualifying events for spouses and dependents that include:

  • Any of the events listed above
  • Death of the covered employee
  • Eligibility of the covered employee for Medicare
  • Divorce from the covered employee
  • Loss of dependent status
  • Legal separation from the covered employee

Qualifying Beneficiary

The last requirement is known as qualifying beneficiary and essentially refers to who is eligible under the law to continue their health insurance coverage with COBRA. This includes:

  • Covered employee
  • Their spouse
  • Any dependents
  • Any new dependents born during COBRA coverage

What Can I Do If I Am Not Eligible For COBRA?

If you determine you are not eligible for COBRA coverage, there are still numerous insurance options out there so that you don't have to do experience a lapse in coverage or a period without health care. The most common insurance that people who are not eligible for COBRA use are private plans offered through major medical insurance companies. These private individual and family plans can offer almost identical coverage to what you had when you were employed, and actually save people money in most cases.

Additionally if you are living close to the federal poverty line, you may qualify for a government insurance plan at a free or reduced cost. This are offered to children, individuals, and families and usually work through community health care centers.

Finally, if you want minimal coverage at a very low cost, you can look into high deductible, short term, or catastrophic plans. These plans offer very minimal coverage with no ongoing care, but will protect you in case of a medical emergency.

No matter what you choose it is wise to always have insurance coverage because you can never predict the future. Medical bills without insurance are virtually impossible to pay without insurance. Additionally, maintaining insurance makes it easier to qualify for a new plan due to the HIPAA plan where you can't be denied coverage if you maintain insurance without any lapse in coverage.

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