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Should I Elect COBRA Health Care Continuation Coverage?


Before deciding to take COBRA, consider the following:

  • Are you eligible for other health coverage - such as under another group health plan, Medicare or Medicaid.       
    • You may be eligible for group coverage through a spouse or an association.
    • You may be eligible for group coverage through a new employer.
    • You are likely to have the right to purchase individual health insurance.
  • If you are not eligible for other coverage, and decline COBRA, how would you get medical care for your health condition?
    • Survivorship A to Z provides information about getting health care without insurance in our document titled Uninsured.
  • If you are eligible for other coverage, would it exclude benefits for your medical condition or require a waiting period before you are covered?
    • If coverage is from a new employer, thanks to the federal law known as HIPAA, it is possible that you will not be subjected to any exclusion or waiting period until coverage starts. If a waiting period is permitted, it is usually limited in duration. To learn more, see HIPAA
    • If there will be a waiting period, consider how likely you are to need treatment for your preexisting condition before it is covered.
    • You must be notified if a plan has a preexisting condition exclusion before the exclusion can be applied to you. However, a plan is not required to give you this notice before your coverage begins. You have to ask for the information if you want it earlier.
    • NOTE: If you become eligible for other group coverage or from Medicare, your COBRA coverage can be cut off. This means that in most situations you would have to decline the other coverage if you decide that you prefer the COBRA coverage.
  • If you would be covered, when can you enroll?
  • Compare costs.
    • How much premium would you pay for COBRA? 
    • How much premium would you pay for the other coverage?
    • How much would you pay for co-pays and other costs you may have to incur?
  • Compare other features which are important to you. For example:
    • Under the other plan, would you be able to see your current doctor(s)?
    • Are your medications covered?
    • Do you need prior approval under one plan but not the other?
    • The reputations of the two companies when it comes to paying claims.
    • Whether there is assistance offered by the insurance company when making treatment and other medical decisions.
    • Do you have the right to purchase individual health insurance if the group coverage ends?

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