Caring for Crohn's & UC

COBRA: My love-hate relationship with insurance gap coverage

July 12, 2013 at 10:29 am Rebecca K. 2 comments

When I left my last job, I thought I was going to immediately start on the insurance plan at my current job. Unfortunately I was wrong- there was a month in which I needed to wait before I could become part of my company’s insurance plan. For many people, this wouldn’t be an issue- just go without insurance for a month and then start on the new plan on the first of the next month. However, when you have an autoimmune disease, you shouldn’t have a lapse in insurance- you never know when something is going to happen where you will need your insurance.

For Dan and I, there was a whole other reason for needing to have insurance during that month- Remicade.

Remicade is administered once every 6-8 weeks to people with moderate to severe Crohn’s disease and ulcerative colitis. Dan has been on Remicade since August 2010 and it has been his miracle drug. He goes every six weeks for a two hour Remicade  infusion and that’s it for his medication. Since Remicade is a miracle drug, it has a hefty price tag associated with it- as much as $10,000 per infusion without insurance.

So here’s our predicament:

I left my last job on May 24 and the insurance from that job expired on May 31. Dan was scheduled to get his Remicade infusion mid-June and, while you can push it back a few days, we couldn’t push it back two weeks until we started on my new insurance. And lord knows, we can’t afford the cost of the drug without insurance.

So what could we do?

In one word, COBRA

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. According to the U.S. Department of Labor, COBRA

“gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events.”  

Essentially, if you leave your job or are fired (or other similar events), you can purchase COBRA insurance at a higher premium than what you paid to cover a gap in insurance coverage. The coverage you get through COBRA is the same as the insurance plan you had with your previous employer- you just pay more for it.

I have a love-hate relationship with COBRA.

I love the fact that there is this option to continue coverage when there is a gap between jobs.

I love the fact that I don’t have to try and purchase private insurance for a short amount of time, especially when Dan can still be denied private insurance due to his pre-existing condition.

I hate how expensive it is.

Because I was the one of us employed, COBRA insurance for one month cost over $1,200 for the two of us. That is more than four times the amount that came out of each paycheck to cover the premium when I was employed at my old job.

Now for one month, that isn’t going to totally break the bank. But imagine if you were to pay for it for several months on end? That’s completely unaffordable unless you are a millionaire.

Sadly, this wasn’t our first COBRA experience. In 2009, Dan had to leave his job to move up to Connecticut to live with me a few months before the wedding. With the job I had at the time, Dan could be put on my insurance that day we got married. However, that left him with a three month gap between when he left his job (and insurance) and when he could get on mine.

We tried to find private insurance for him but he was denied by three different companies due to his Crohn’s disease. So we bit the bullet and he enrolled in COBRA for the three months.

It was a little more affordable that time, as we were only paying for him to be on COBRA. It cost around$500 each month, so $1,500 total for the time he was on it. Yes that’s significantly more than you would pay for insurance through an employer but it’s better than the alternative.

Love or Hate?

I suppose I love COBRA more than I hate it.

Enrolling in COBRA allows us to have insurance and not have to shell out thousands upon thousands of dollars to pay for Dan’s medication (and mine as well, although they are significantly less expensive).

But with health care reform and the goal of making health insurance more affordable for people, doesn’t COBRA seem somewhat contradictory and unreasonable?

Entry filed under: Affordable Care Act, Caregiving, Finances, General Disease, Medication.