Author Topic: COBRA Dental/Vision with ACA Medical?  (Read 1008 times)

CalBal

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COBRA Dental/Vision with ACA Medical?
« on: April 02, 2019, 10:45:24 PM »
[Edit: I moved this topic to the post FIRE forum thinking perhaps some folks here have gone through this. It didn't really seem like anyone on the general forum had any opinions as to whether this was possible or not.]

Despite the recent news of the reversal of the Trump administration's opinion of the ACA and subsequent striking down of the law (and subsequently landing in federal appeals court), I have a question that maybe one of you smart people already know the answer to. Before I continue, I will say that I am currently on a leave of absence from my job and will likely leave it in the next 30 days, and need to make a decision re: COBRA vs the ACA. This question may be a moot point if the law is immediately struck down and the ACA crumbles. This is an important consideration, but I can't see the future, so... I believe that I am eligible for COBRA via my current employer for 18 months, however, it is quite expensive. I also am covered by a vision and dental plan (and yes, vision is important for me, I am blind as a bat without significant prescriptions).

The COBRA forms sent to me indicate I can elect Medical, Dental, and Vision coverage via COBRA individually (meaning I can keep some but not all if I chose). What is unclear is if, say I elect to only keep Dental and Vision, if I can then get Medical coverage via the ACA using the Special Enrollment rule (leaving a job). It seems like the answer is yes, since Vision and Dental are completely silo-ed away from Medical, but I am not sure, since COBRA is an option. Does anyone have experience/knowledge with this? It is unclear to me.

I'm also wondering if a person elected COBRA Medical for the moment, could that person switch to ACA coverage during the next open enrollment? Would the fact that they still were eligible for COBRA for some more months throw a wrench in that plan?

The reason this is a difficult decision is that a silver ACA plan with subsidies based on an estimated income for 2019 is something like $400 cheaper per month than COBRA coverage for Medical. The COBRA Dental and Vision are quite reasonable. In addition, I still need to have some expensive dental work done this year that cannot wait a 12 month waiting period that ACA Dental plans have. It makes sense to extend the Dental and Vision via COBRA if it is still possible to get Medical via ACA Marketplace.

Of course if the ACA immediately goes away it would be a stupid decision to not sign up for COBRA. If it takes a year or more, it makes sense to use ACA while I can. I am not sure if/when I will go back to a job that includes health insurance coverage, so that may change things as well, but again, I can't predict the future, and everything is in flux right now.

Also - I did see the "What comes after the ACA" thread, but it's over 100 pages long. If there are relevant posts I would be interested to be pointed to them, reading the entire thing would take an enormous amount of time.

Any thoughts?
« Last Edit: April 05, 2019, 03:25:48 PM by CalBal »

ysette9

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #1 on: April 02, 2019, 11:06:34 PM »
I can’t hope to summarize that thread, but I  believe the general consensus is that it was a rather creative interpretation of the law by an activist judge that most likely won’t hold up at all. I wouldn’t go so far as to say that the ACA has been struck down. It is the law of the land and has been for a good while now. If the Supreme Court really does rule against it, it would disrupt an entire entrenched system and cause massive chaos for millions of people. Hopefully there are still some adults awake at the wheel.

MonkeyJenga

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #2 on: April 03, 2019, 08:34:19 AM »
I'm in a similar situation, but with COBRA dental and possibly Medicaid expansion medical. Interested to see responses.

soccerluvof4

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #3 on: April 03, 2019, 12:44:56 PM »
I agree with @ysette9 its not going to go away but to answer your question I was in the same position a couple years back because of retiring and the Election. I decided to pay a bit more and keep Cobra because I knew what I had and take more time to see how things are going to go.

lhamo

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #4 on: April 03, 2019, 01:23:17 PM »
If you need vision exams for health reasons (e.g. prior surgery + high risk of retinal detachment, which is my reason for referral), that might be covered by an ACA plan.  If you only are looking for exams to update corrective lenses, you can do that pretty cheap so the extra cost on coverage might not be worth it.  New glasses can be very cheap once you have the prescription -- I paid $100 for my Warby Parkers (which I could try on in their local store) and then $25 for a similar backup pair via Zenni.com.  In my experience, adult corrective lens prescriptions can be written for 2 years, so if you get a exam now the prescription would be valid for longer than you have Cobra anyway.

If you are in an expanded medicaid state basic vision exam and dental exams/dental cleaning may be covered.  Glasses are covered for kids, but with a limited choice of frames.  Adult glasses are not covered (which pisses me off....)

Paul der Krake

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #5 on: April 03, 2019, 01:51:10 PM »
Dental and vision "insurance" are terrible products that should only be "purchased" when someone else (usually an employer) is footing the bill.

CalBal

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #6 on: April 03, 2019, 02:37:48 PM »
Thank you to the people who responded so far.

@soccerluvof4 , I understand keeping that level of comfort, I considered it (briefly) but going with COBRA is 200% more for essentially the same level of coverage. It's $1800 vs $5400 for the remainder of the year. That is not an insignificant amount that I can't ignore. I have no major health conditions (that I know of currently, except the dental) that require me to stay with the same providers, which is why I am entertaining an ACA plan.

@lhamo I have a history of corneal ulcers that make getting yearly exams and sometimes scans recommended. I don't (yet) have any degenerative conditions. But I do need (want) to get ultra light lenses with protective coatings, and ultra light frames - my prescription is quite significant, and "standard" lenses and frames are quite heavy on my face and can cause headaches. I don't know how I feel ordering something online that I can't try on in advance (I don't know if there are any stores locally I can use) and get all the correct measurements and feel comfortable getting a product that I ultimately will be unhappy with. Maybe for a backup pair, but I wear glasses all day every day, I cannot function without them. I don't know. They are a very important part of being able to live. Plus, I'm pretty picky with the ones I have been able to chose from in the past. It would royally suck to get some that I hated the way I looked in. It might be worth it to just pay upfront for exam + lenses + frames (I do need new frames, my old ones just broke, and my backup pair are so old the prescription is so far out o date they give me headaches.)

My state does not have expanded Medicaid coverage, and none of the medical ACA plans (I don't think) that I can get here cover dental.

@Paul der Krake Even if I did decide to drop vision, I would still need Dental. I have thousands of dollars in oral surgery likely. My dental covers half for minimal monthly premium. It absolutely is worth it.

Having said all that, I'm still hoping to hear from anyone if they have been able to "mix and match" COBRA with ACA. This is what I am most in the dark about.

CalBal

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #7 on: April 09, 2019, 08:16:21 PM »
I'm in a similar situation, but with COBRA dental and possibly Medicaid expansion medical. Interested to see responses.

Well, I tried. I guess no one knows. Or wants to talk about it. Not sure what I am going to do.

freeatlast

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #8 on: April 11, 2019, 01:14:17 AM »
My understanding is that COBRA follows your former employer's health plan. So, if your job offered dental and vision as options separate from medical, then you can take dental and do medical under the ACA or do any combo.  When I left my job recently, I took only dental for COBRA to finish up some work and not medical. As I will hit my max I am going to cancel the dental soon. My understanding is that you can cancel your COBRA coverage anytime and, so yes, you can do medical COBRA now then switch to the ACA during open ACA enrollment which will probably still exist at least for 2020. Or, just start ACA now. I knew I was leaving my job, so I did every medical test known to man before I left - I am going to roll the dice and go bare til open enrollment in the ACA in 2020 since its only 8 months. If something goes wrong, I guess I will be a medical tourist :) That's probably not a smart choice... I have one week left to change my mind and take COBRA......

Need2Save

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #9 on: April 11, 2019, 06:24:33 AM »
Benefits professional here.  Yes, you can take COBRA for dental and/or vision and not medical. That is your right.  However, you can't take ACA medical and then later decide that you want COBRA after all (once your election window closes). Once you waive the right to COBRA for a specific plan, you can't go back essentially. But, you can take medical COBRA initially and then decide to cancel at the end of December and sign up for ACA as of January 1 during the ACA open enrollment season.  Even then, you could continue dental and/or vision next year as long as you are within your 18 months (some events allow more than 18 months but 95% of COBRA eligible events are the standard 18 months).  Did you have additional questions?

CalBal

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Re: COBRA Dental/Vision with ACA Medical?
« Reply #10 on: April 11, 2019, 09:54:56 AM »
My understanding is that COBRA follows your former employer's health plan. So, if your job offered dental and vision as options separate from medical, then you can take dental and do medical under the ACA or do any combo.  When I left my job recently, I took only dental for COBRA to finish up some work and not medical. As I will hit my max I am going to cancel the dental soon. My understanding is that you can cancel your COBRA coverage anytime and, so yes, you can do medical COBRA now then switch to the ACA during open ACA enrollment which will probably still exist at least for 2020. Or, just start ACA now. I knew I was leaving my job, so I did every medical test known to man before I left - I am going to roll the dice and go bare til open enrollment in the ACA in 2020 since its only 8 months. If something goes wrong, I guess I will be a medical tourist :) That's probably not a smart choice... I have one week left to change my mind and take COBRA......
Thanks @freeatlast for recounting your experience! I should have done the same (getting everything done prior) but I didn't really quit on a schedule and had a lot of... stuff... happening all at that time. I'm a healthy individual too, but I'm in my 40s and IDK, there's just increasing potential for something coming up at this point in my life I am hesitant to forgo medical altogether!

Benefits professional here.  Yes, you can take COBRA for dental and/or vision and not medical. That is your right.  However, you can't take ACA medical and then later decide that you want COBRA after all (once your election window closes). Once you waive the right to COBRA for a specific plan, you can't go back essentially. But, you can take medical COBRA initially and then decide to cancel at the end of December and sign up for ACA as of January 1 during the ACA open enrollment season.  Even then, you could continue dental and/or vision next year as long as you are within your 18 months (some events allow more than 18 months but 95% of COBRA eligible events are the standard 18 months).  Did you have additional questions?

Oh @Need2Save you have saved me. This is exactly what I wanted to verify, but couldn't find in writing anywhere! (And our benefits department (at former employer) is not that responsive...) Our medical plan is ok but nothing spectacular, so getting an ACA plan is wayyyyy cheaper than paying for COBRA medical. But like I said, keeping dental is pretty valuable (and maybe vision for my needs, I have to calculate it out). Even if ACA goes away say in mid 2020 I really would only get a few months extra of insurance from sticking with COBRA medical, because it is the standard 18-months, so it isn't worth it. THANK YOU!!! This helps me so much! :) :) :)