Question:
Does your insurance company know when you are on COBRA
I know that COBRA should not technically make a difference in your insurance coverage, but I was wondering if the insurance company knows when someone is one COBRA. It just seems to me that it might affect getting approval. If the medical review board (or, as one rep accidently let slip to me - the "cost containment department") knows that I am on COBRA and can only be on it for 18 months, then it seems more likely that they would stall, deny, stall, deny, etc. until I was no longer eligible for insurance. Anyone??? — Tired P. (posted on August 5, 2002)
August 5, 2002
I don't believe they are aware. They just know whether or not their
monthly premium has been paid, either by your employer or by you directly
(through COBRA). I don't think it matters to them, since they follow
written guidelines to make the determination anyway.
— Terissa R.
August 5, 2002
Yes. In the insurance company computer it says Cobra account. They are well
aware of cobra patients, but they do have to answer you in a set amount of
time (varies by state).
— Lesa H.
August 5, 2002
I can only speak for Bariatric Treatment Centers in Michigan but They
specifically ask you when you are called by the Surgery Schedule Rep for a
date, "Are still currentlly insured through --------, and are you
subscribed under a COBRA plan?" I don't know what her response would
have been if I had been but I do know if you deny or purposefully conceal
the truth it is fraud and they automatically find out when the bill is
submitted to your insurance for paymt. Some COBRA policies have exclusion
of certain benefits when discontinued through the employer and are suppose
to only be a temp. coverage until new insurance is obtained. Trying to cut
the time line might get you stuck with the bill, which is a heavty one!
Good Luck
— Rebecca B.
August 5, 2002
Yes, they definately know when you are on COBRA. Although it SHOULD not
change their policies and procedures for authorization and approval
process. I would keep on top of them if I were you.
— Vicki L.
August 7, 2002
I do know that they know when you are on COBRA. However, my cousin, and a
friend of mine got approved. They may stall, but the fact is they still go
by your insurance guidelines. They do have a certain amount of time, to get
back to you. I wouldn't worry, in the end it all comes down to the
insurance anyhow.
— Laydie K.
August 7, 2002
I processed billing for my old employer which included being linked to Blue
Cross Blue Shield database. Unless the employer sends in the status/change
form to your insurance company the insurance company does not know you are
"cobra status". All the insurance company sees is your level of
coverage, single, 2-person or family. As far as the insurance premiums,
those premiums with the insurance company are the same as any other
employee with the same level of coverage. What you pay your employer may
include a 2% administrative fee, basically the employers profit.
The bottom line is, whether your status is active employee or active cobra
it should not have any effect on them approving or denying your surgery. I
would make sure your document all your dates at home, like when stuff is
submitted to them, you know, so you have record of stall, deny if that
happens. If this does happen, they better have darn good reason. Just make
sure you do everything on your part to co-operate with the insurance
company and get them any further documentation they may need.
Good luck and God Bless!
— stacjean
August 7, 2002
I had my surgery in Aapril while I was on Cobra. During the 18 months I
was on Cobra I used the same card that I used before the insurance was
changed over to Cobra. It only took 3 weeks to get approved. Any
questions e-mail me at [email protected]
— Judy S.
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