Q: My husband and I have our insurance under the COBRA law through my former employer. I was three months behind in paying the premium to my former employer and they cancelled my coverage. Can they do that?
A: Yes! When you are continuing health insurance coverage under the COBRA law or NJ Continuation, it is MOST imperative that you pay the premium on time to your former employer each month. If you are so much as a day late, you can be dropped from the plan.
Q: My wife is in the hospital and they want to admit her to a nursing home. She has Medicare and a Medicare supplement. Who is going to pay for the nursing home?
A: Medicare pays for about 2% of all nursing home stays. Medicare will only pay if you have been in the hospital for at least 3 days and are admitted to the nursing home within 30 days of hospital discharge for the same diagnosis for which you were in the hospital. Furthermore, Medicare will only pay if you require SKILLED nursing care by Medicare’s definition. If Medicare approves the nursing home stay, they will pay in full for 20 days and then all but $101.50 until day 100, provided you still need skilled nursing care. Many Medicare supplements will pay the $101.50. If you had purchased a good Long Term Care policy earlier, that policy may offer benefits to cover the nursing home stay. If not, get out the check book and be prepared to write some very large numbers. Nursing home stays are not inexpensive. In Morris County NJ $250- $300 a day is average. If you have a very low income, you may quailify for Medicaid which is the state and federally funded welfare program.
Q: I let my life insurance lapse 2 years ago because I am relatively young, (in 40’s) and healthy. I was just diagnosed with cancer, and am wondering if I can get the policy reinstated.
A: No. If it had just lapsed a few weeks ago you may have had a chance of getting it reinstated, but over two years ago, the answer is no. Furthermore, most companies will not write a life insurance policy for you now until you are a few years past your treatment date. The good news is that it is possible to get life insurance after such a diagnosis, the bad news is you have to wait until you are done with treatment and have been asymptomatic for a certain number of years, depending on the life insurance company.
Q: I just learned that I will be out of work on disability for an undetermined amount of time – can I continue my insurance under the COBRA law?
A: The COBRA law allows you to continue your benefits when they would otherwise terminate due to the loss of your job, death of the insured, divorce, or dependent children coming of age. It does not allow for continuation due to disability. However, if you are disabled, you are able to stay on your employers’ health insurance plan indefinitely. You are responsible for the premium, of course, but being able to continue the group benefits indefinitely is certainly a wonderful option for many individuals in this position.
Irene Card & Betsy Chandler share the responsibilities of running Medical Insurance
Claims, Inc. a health insurance services company. If you have questions relative to this
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