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RE: COBRA

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Helpful COBRA information and definitions can be

found on this website:

http://www.dol.gov/dol/topic/health-plans/cobra.htm

Below is the section pertaining to Medicare:

The

operative word in 1st sentence of the 2nd paragraph

is “may” – a company can choose to continue to offer

COBRA if beneficiary becomes entitled to Medicare benefits.

And even if

the company choose to drop the COBRA option for a beneficiary, the family

of the beneficiary can still be covered by COBRA (but then they are paying

the COBRA, the Medicare premiums, and premiums for a gap plan if they can

find one)

Attached are 2 documents from the NKF website (from

2007) which I find helpful. Also helpful is the NKF (National Kidney

Foundation) publication Taking Control: Money Matters for People with

Chronic Kidney Disease – available free (yes, multiple copies) from

NKF.

****************************************

From the US Department of Labor

How long does COBRA

coverage last?

COBRA establishes required periods of coverage for continuation health

benefits. A plan, however, may provide longer periods of coverage beyond those

required by COBRA. COBRA beneficiaries generally are eligible for group

coverage during a maximum of 18 months for qualifying events due to employment

termination or reduction of hours of work. Certain qualifying events, or

a second qualifying event during the initial period of coverage, may permit a

beneficiary to receive a maximum of 36 months of coverage.

Coverage begins on the date that coverage would otherwise have

been lost by reason of a qualifying event and will end at the end of the

maximum period. It may end earlier if:

§

Premiums

are not paid on a timely basis

§

The

employer ceases to maintain any group health plan

§

After

the COBRA election, coverage is obtained with another employer group health

plan that does not contain any exclusion or limitation with respect to any

pre-existing condition of such beneficiary. However, if other group

health coverage is obtained prior to the COBRA election, COBRA coverage may not

be discontinued, even if the other coverage continues after the COBRA election.

§

After

the COBRA election, a beneficiary becomes entitled to Medicare benefits.

However, if Medicare is obtained prior to COBRA election, COBRA coverage may

not be discontinued, even if the other coverage continues after the COBRA

election.

Daryl Battin,

LICSW

Financial

Coordinator/Social Worker

Lahey Clinic Kidney

Transplant

41 Mall Road, Burlington,

MA 01805

Ph:

/FAX:

Page:

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Austria,

Sent: Tuesday, October 07, 2008

6:33 PM

To:

TxFinancialCoordinators

Subject: RE:

Pancreas Tx

after Kidney Tx

Some employers allow their employee to continue to be covered by

COBRA when they become eligible for Medicare. Also there are some plans that

specifically mention on their employee benefit book, that should the employee

becomes eligible for Medicare, then they are not eligible for COBRA coverage.

Austria

Specialty Contracting

Methodist Health System

1441 North Beckley Avenue

Dallas,Texas 75203

Phone:

Fax:

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Phyllis Lang

Sent: Tuesday, October 07, 2008

3:44 PM

To: TxFinancialCoordinators

Subject: RE:

Pancreas Tx

after Kidney

Tx

My understanding is: If patient has cobra and becomes Medicare

eligible then they'll lose cobra. If patient had Medicare at the time of

cobra election then cobra will continue.

So if patient had Medicare at time of cobra election his insurance

should be primary d/t being in the 30 month coordination period.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Villalta, Lilly

Sent: Tuesday, October 07, 2008

4:29 PM

To: TxFinancialCoordinators

Subject: RE:

Pancreas Tx

after Kidney

Tx

Yes, but pt did receive the kidney transplant within the

coordination period.

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Phyllis Lang

Sent: Tuesday, October 07, 2008

1:27 PM

To: TxFinancialCoordinators

Subject: RE:

Pancreas Tx

after Kidney

Tx

was the patient in his 30 month coordination period

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Villalta, Lilly

Sent: Tuesday, October 07, 2008

4:24 PM

To: TxFinancialCoordinators

Subject: RE:

Pancreas Tx

after Kidney

Tx

Hi

Everyone...

I have a pt who was awaiting a kidney/pancreas transplant... Received

kidney transplant only and is now pending pancreas transplant alone. Pt

had United Healthcare primary through employer and Medicare eff 4/1/08

due to ESRD secondary. United Healthcare is now COBRA. Pt received

kidney transplant 5/1/08.

Is Medicare primary?

Thanks,

Lilly Villalta

Transplant Counselor

Transplant Administration

UCLA

Medical Center

Ofc 310/794.3494

Fax 310/794.8951

IMPORTANT WARNING: This email (and any attachments) is only intended for the

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Unauthorized redisclosure or failure to maintain confidentiality may subject

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IMPORTANT WARNING: This email (and any attachments) is only

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and state penalties. If you are not the intended recipient, please immediately

notify us by return email, and delete this message from your computer.

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System and should be considered confidential and privileged. The

information contained in the above messages is intended only for the

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See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

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