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Can individuals qualify for longer periods of COBRA continuation coverage? What about COBRA alternative coverage?

COBRA eligibility normally ends at 18 months but may be extended beyond the normal 18 month maximum term under the three specific situations described below:

1) In New York State, the eligibility period is 36 months. See http://www.dfs.ny.gov/insurance/faqs/faqs_cobra.htm for more information.

2) a second qualifying event may extend the coverage to 36 months. See the chart below.

entension of COBRA coverage

3) If any one of the qualified beneficiaries in your family is disabled and meets certain requirements, all of the qualified beneficiaries receiving continuation coverage due to a single qualifying event are entitled to an 11-month extension of the maximum period of continuation coverage (for a total maximum period of 29 months of continuation coverage).

To qualify for these additional months of COBRA continuation coverage due to disability, the qualified beneficiary must:

  • Have a ruling from the Social Security Administration that he or she became disabled within the first 60 days of COBRA continuation coverage
  • Send the plan a copy of the Social Security ruling letter within 60 days of receipt, but prior to expiration of the 18-month period of coverage

If these requirements are met, the entire family qualifies for an additional 11 months of COBRA continuation coverage. Plans can charge 150% of the premium cost for the extended period of coverage.

It is important to realize that the required combination of qualifying events is very rare. Even when a person is clearly disabled, Social Security Administration rarely make an affirmative ruling within the 18 month specified period of time.

Extension of benefits under a COBRA alternative plan is entirely controlled by the provisions of the specific insurance contract.

Most of the low cost short term medical insurance plans, for example, expire at the end of a 6 or 12 month maximum term and may be extended only if the insured person is hospitalized at the time of normal policy expiration. It is possible to enroll in a new short term policy for another 6 to 12 month term to extend coverage although sometimes, due to state law or the insurance company's rules, the new policy must be obtained through a different insurance company.

Regular individual major medical insurance and most limited benefit or "mini-med" insurance plans have no date of expiration and may be extended indefinitely.  State-by-state listings of these plans are available on the Freedom Benefits Insurance Exchange.

Other resources:

Which short term medical insurance is best for me?

Ten things you should know about short term medical insurance after health reform

Finding health insurance to cover pre-existing medical conditions

revised 12/7/2011

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