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Medicare and COBRA
Jul 25, 2000

I returned to work full-time in Nov. 1997 after my health improved. I was on Social Security Disability and my drugs were provided by Texas ADAPT. Medicare finally kicked in and after a year on the job, my employer provided insurance also kicked in and covers my drugs and anything Medicare doesn't pay. My place of work only has 7 full-time employees. The best thing was that I finally got away from District Clinic (indigent care) and got a good doctor before the one I had almost killed me. He missed pneumonia that had me in the emergency room and a hospital stay within 3 hours of him telling me to "go home, you have a sinus infection."

Well, my health is dropping off, my viral load is back. I get tired and wiped out feeling everyday. I've developed hyperlipidemia and all the numbness from ritonavir just keeps coming back.

Is there any hope for me to leave my job and COBRA my insurance even though I have Medicare? My employer keeps resisting my pleas for only part-time work. I'm paid a salary of $16,000 a year but am constantly having to work 60-70 hour weeks. I took an unpaid 5 week leave of absence 2 months ago but didn't feel refreshed when I returned to work.

I would like to find a good, hourly paid, part-time job - but those jobs usually don't offer insurance.

I don't want to lose my doctor, and this just doesn't seem to be the time to cut corners with lab tests if I didn't have my current insurance.

What options do I have?

Response from Ms. Breuer

Typically a person is eligible to have COBRA continuation coverage even if he has Medicare. According to the COBRA regs, COBRA coverage will stop when a person first becomes eligable for Medicare after the effective date of his COBRA election. The interpretation of this has been that if someone is on Medicare when he loses employer-provided coverage, that person is still eligible for COBRA because the Medicare eligibility did not occur after the COBRA effective date. However, COBRA doesn't apply to small employers (those with fewer than 20 employees) so you would not have COBRA available to you.



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