No idea how to TL;DR this one. I think it’s a doozy.
My spouse and I have coverage under his current employer. For the purposes of this question, please assume that he will be ending his current employment on August 31 and beginning his new employment on September 1. Assume also that our baby is due September 1, and that early elective induction is not an option. We expect the baby to be born in September since it is our first child. We have confirmed that our current coverage (PA employer) will end on August 31 and our new coverage—should we enroll immediately—would begin on September 1 (NJ employer). We are and will remain PA residents.
The OB practice/providers and hospital that we have used for prenatal care are not in-network with the new employer’s plan. We plan to use COBRA to extend our current coverage through the month of September so that I can deliver at the hospital where I’ve been receiving care. We have…questions.
To save money, we would prefer to decline initial coverage through the new employer so that we are covered only through COBRA until the birth of our child. We would then use the birth of our child as a qualifying event to enroll in the new employer’s insurance. Should our child be stillborn, or should they die immediately after birth, is it likely that their birth would still be considered a qualifying event? I hate that I have to ask this question, but my spouse and I could not comfortably afford to continue COBRA coverage until the new employer’s next open enrollment period, so I have to ask. If either stillbirth or immediate death do not constitute a qualifying event, my spouse and I will likely elect to enroll in his new employer’s insurance alongside COBRA. Assuming that we pay the entire portion of the premium on time, can our plan through COBRA cancel our coverage based on the fact that we have other insurance?
If we elect to enroll in my spouse’s new employer’s insurance alongside COBRA and COBRA cannot cancel our coverage based on that fact, how will the hospital/doctors/whatever bill our two insurances? Would one insurance or the other be considered the “primary,” and what implications does would that have? In other words, would we be able to take advantage of the fact that the hospital and doctor are in-network with our COBRA plan, or would we be stuck with a huge deductible since they are not in-network with my spouse’s new employer’s insurance?
Would getting any of the above answers from my spouse’s current employer’s COBRA Administrator in writing be at all useful…? If so, how do you suggest we approach this? By email? We have not been having much luck contacting my spouse’s current employer’s COBRA Administrator with these questions. Would the hospital/OB practice/someone on the provider side be able to answer these questions?
Am I missing anything? If I am missing a ton, I blame it all on pregnancy-induced insomnia…!
THANK YOU in advance for reading and considering…and for directing your very best late-August-birth-vibes our way ;).
submitted by /u/__discosuperfly
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No idea how to TL;DR this one. I think it’s a doozy. My spouse and I have coverage under his current employer. For the purposes of this question, please assume that he will be ending his current employment on August 31 and beginning his new employment on September 1. Assume also that our baby is due September 1, and that early elective induction is not an option. We expect the baby to be born in September since it is our first child. We have confirmed that our current coverage (PA employer) will end on August 31 and our new coverage—should we enroll immediately—would begin on September 1 (NJ employer). We are and will remain PA residents. The OB practice/providers and hospital that we have used for prenatal care are not in-network with the new employer’s plan. We plan to use COBRA to extend our current coverage through the month of September so that I can deliver at the hospital where I’ve been receiving care. We have…questions.
To save money, we would prefer to decline initial coverage through the new employer so that we are covered only through COBRA until the birth of our child. We would then use the birth of our child as a qualifying event to enroll in the new employer’s insurance. Should our child be stillborn, or should they die immediately after birth, is it likely that their birth would still be considered a qualifying event? I hate that I have to ask this question, but my spouse and I could not comfortably afford to continue COBRA coverage until the new employer’s next open enrollment period, so I have to ask. If either stillbirth or immediate death do not constitute a qualifying event, my spouse and I will likely elect to enroll in his new employer’s insurance alongside COBRA. Assuming that we pay the entire portion of the premium on time, can our plan through COBRA cancel our coverage based on the fact that we have other insurance?
If we elect to enroll in my spouse’s new employer’s insurance alongside COBRA and COBRA cannot cancel our coverage based on that fact, how will the hospital/doctors/whatever bill our two insurances? Would one insurance or the other be considered the “primary,” and what implications does would that have? In other words, would we be able to take advantage of the fact that the hospital and doctor are in-network with our COBRA plan, or would we be stuck with a huge deductible since they are not in-network with my spouse’s new employer’s insurance?
Would getting any of the above answers from my spouse’s current employer’s COBRA Administrator in writing be at all useful…? If so, how do you suggest we approach this? By email? We have not been having much luck contacting my spouse’s current employer’s COBRA Administrator with these questions. Would the hospital/OB practice/someone on the provider side be able to answer these questions?
Am I missing anything? If I am missing a ton, I blame it all on pregnancy-induced insomnia…!
THANK YOU in advance for reading and considering…and for directing your very best late-August-birth-vibes our way ;).
submitted by /u/__discosuperfly [link] [comments]Read Morer/HealthInsurance