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pkearse
Oct 11, 2011, 02:27 PM
My wife is permanently disabled. She enrolled in her employer's COBRA plan. 16 months later she received a letter from Ceridian, plan admin, informing her that her coverage was terminated effective 10/31/2011. After several letters and phone calls, she was told that she was ineligible because she did not notify them within 60 days of her disability notification from SSA. This requirement went unnoticed by us. In fact, I have no knowledge of it prior to their letter of termination. It seems very unfair. Well,this was horrifying info as her disease is very expensive to treat. We live in SC and I would appreciate any advice that anyone has to offer re an appeal and any coverage that may be available at the state level. She is 61.

Thanks

twinkiedooter
Oct 11, 2011, 02:32 PM
Her disability benefits include Medicare after so many months of being on disability. How long has she been on SS disability?

joypulv
Oct 11, 2011, 02:49 PM
I don't have proof of any statement from COBRA saying that you must notify them if you get SS and Medicare, but you do, and it stands to reason that you would so that coverage is not duplicated. I don't know if you can appeal or not, or what would happen if you paid a lawyer to appeal for you.
I can say gather your financial papers together and go to the nearest state benefits office to see if she qualifies for Medicaid. If you do have assets (your home doesn't count, and a car under a certain value) over the limit, then look into Medicare supplement plans such as from AARP.
Also be clear about what medications are covered under Medicare, Medicaid, and any other plans. Many states have their own for people who fall through the cracks. You will have choices of carriers and they are different, and there are deadlines for signing up. If it's all too confusing, call around to senior centers and the town social worker.

pkearse
Oct 11, 2011, 05:29 PM
She was declared disabled 1/1/10. She was approved by SSA om March 23, 2010. Her payments started June1, paid on July 28. She was disabled when she applied for Cobra.
SC has 2 insurers who will accept people under the medicare age. I cringe at the potential rates.
I do not understand why the 60 day window opens and closes. Failure to provide your COBRA admin with the SSA awards letter within that period, results in the denial and no appeals process for the 11 month extension. It is simply diabolical and surely is meant as a way for health insurers to force eligible people off the Cobra plan because of some obscure requiremnt. Never any notices from anyone advising of that 60 day period. In that my wife was disabled when she went on the Cobra plan offered by her employer, it would seem that it would be a non issue. I am outraged and extremely discouraged as she will forego medicine that is essential to her well being. The cost of one oof her meds is over 10k per month. Does anyone know of a way to appeal such an assinine and petty requirement intended to kick people out of the 11 month extension if they did not have an attorney handle the whole process? When someone becomes disabled, that is not the time to insert mundane and ridiculous requirement such as the 60 day window. TThanks

pkearse
Oct 11, 2011, 05:30 PM
Since June of 2010.

pkearse
Oct 11, 2011, 05:32 PM
She has been receiving disability benefits since June 2010. She was declared disabled on January 1, 2010. Her last day of work was Dec 31, 2010.