Jump to content
×
Are you looking for the BariatricPal Store? Go now!

COBRA insurance question..losing my Aetna



Recommended Posts

If I am not approved by Aetena by the time my husband leaves full-time employment within days (which my Dr. thinks Aetna knows is about to happen, hence the wait), do i then have to re-apply thru COBRA? It is supposed to be a continuation of coverage, but is Cobra like it's own insurance company and thus could deny my request for VSG ?

Additionally, the Hilton gives NO grace period. The day you leave full-time emp, is the day your bennies end. We can get COBRA, but we can't get COBRA until after he leaves the Hilton and they send us paperwork, so essential a gap in coverage (that is retro-active). So then I guess I'd have to make sure my surgery isn't right around that time, because of the 'gap'.

Share this post


Link to post
Share on other sites

COBRA is a continuation of the exact benefits you have today - you just pay the full price of the coverage. You have 56 days to apply/pay and you get back dated to the day coverage ended. To keep "active" vs "COBRA" members accounted for in the systems, you may get a new ID card, but there will be no break in coverage. You should not have to re-submit your paperwork since you have the same benefits, etc. If they tell you that you do, ask for a supervisor immediately!

Share this post


Link to post
Share on other sites

COBRA is a continuation of the exact benefits you have today - you just pay the full price of the coverage. You have 56 days to apply/pay and you get back dated to the day coverage ended. To keep "active" vs "COBRA" members accounted for in the systems, you may get a new ID card, but there will be no break in coverage. You should not have to re-submit your paperwork since you have the same benefits, etc. If they tell you that you do, ask for a supervisor immediately!

THANKS! That makes sense. So I might not get my surgery on Monday as scheduled (the job cuts your bennies the DAY you leave), but as soon as they send the COBRA paperwork and we pay (for just me), then it is On like Donkey Kong. Ironically, last year I had 100% coverage for this surgery, then they changed the plan and I've had to pay $1,000 hospital and $400 to Dr. plus since my hubby got a new job without WLS coverage, I also have to pay for 2 months Cobra to cover surgery and complications. Irony of ironies. But that is still cheap and about what I thought I'd have to pay before I started anyway.

Last night when I was so down and thought I'd missed the timeline I wasn't sure if I was happy or sad, since I am afraid of surgery (dr's done 1000 baratric combined with no deaths), but also dammmm tired of lugging around at least 100 extra pounds, I'm realllly tired of that. Its like I am dragging around a crash cart on my butt all day. LOL and I am not even in medical!

Colette!

Share this post


Link to post
Share on other sites

Glad that I was able to help out.

As far as surgery on Monday ... COBRA is guaranteed & as long as you complete the paperwork and pay in the required timelines, it is back-dated to the day your coverage ended. So, you can go ahead and have the surgery. Just be sure you don't forget to dot any i's or cross any t's on the paperwork! :o)

Share this post


Link to post
Share on other sites

Glad that I was able to help out.

As far as surgery on Monday ... COBRA is guaranteed & as long as you complete the paperwork and pay in the required timelines, it is back-dated to the day your coverage ended. So, you can go ahead and have the surgery. Just be sure you don't forget to dot any i's or cross any t's on the paperwork! :o)

Monday may be off, I am actually STILL waiting on insurance approval. There were more records ordered today from some confusing info in my paperwork. (did I mention the freaking change in bennies, now 20% of everyone and 1k at hospital from 100% coverage last year, so about 2K, 3K after co-pays, diet, psy, sigh...hubby is annoyed I didn't do this sooner!!) ANYWAY, if they don't call me in the next hour, I am going to consider it off for Monday.

So, as I understand it, if my hubby loses coverage this Monday thru Hilton (as that is the day he is moving from full-time to either part-time as planned, or putting in 2 week notice, but not coming back in for any days, better for them to let him "keep" insurance those 2 weeks, as we are not on at new job yet either), I can have surgery the next Monday (as how it is looking)? Worry that hospital calls Aetna, who says I'm gone, before I can actually get to Cobra, so all gets postponed, either way, if approved, I'll get in soon, nice job giving me a window in which to work with Aetna!

Share this post


Link to post
Share on other sites

I work as an insurance broker so I'm aware of this situation a lot. What insurance carriers are "supposed" to do is to say that your benefits are inactive but you are in your COBRA election period. What I would do is to call the HR person at your husband's company and find out from her what the amount will be for coverage and send in the payment. Let them know that you have a surgery coming up so you can't have a break in coverage, that you don't want to wait for it to come in the mail. Sometimes that helps get the paperwork out even faster. It does depend on the company though. You may want to ask if the company uses a COBRA administrator or if they handle it themselves. If it is through an administrator, you can ask the HR person if you can just pay for one month directly to them to avoid any delays due to paperwork. That is the way I would proceed to keep yourself active.

Monday may be off, I am actually STILL waiting on insurance approval. There were more records ordered today from some confusing info in my paperwork. (did I mention the freaking change in bennies, now 20% of everyone and 1k at hospital from 100% coverage last year, so about 2K, 3K after co-pays, diet, psy, sigh...hubby is annoyed I didn't do this sooner!!) ANYWAY, if they don't call me in the next hour, I am going to consider it off for Monday.

So, as I understand it, if my hubby loses coverage this Monday thru Hilton (as that is the day he is moving from full-time to either part-time as planned, or putting in 2 week notice, but not coming back in for any days, better for them to let him "keep" insurance those 2 weeks, as we are not on at new job yet either), I can have surgery the next Monday (as how it is looking)? Worry that hospital calls Aetna, who says I'm gone, before I can actually get to Cobra, so all gets postponed, either way, if approved, I'll get in soon, nice job giving me a window in which to work with Aetna!

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
      · 0 replies
      1. This update has no replies.
    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×