Overview
Once you have selected which plans you will continue under COBRA and you have paid for the first month of coverage, the reinstatement of your coverage with various insurance companies will begin. Coverage under COBRA will be retroactive from your last day of coverage as an active benefits participant. This reinstatement normally takes between 5 and 10 business days from when your first full month of COBRA payment is processed. Your reinstatement is typically not completed before the effective date of your COBRA coverage. This is due to the timing between when COBRA elections are made after the normal coverage termination dates and when Vita typically receives COBRA Qualifying Event information.
Coverage Not Active
What should you do if your coverage is not showing as active? It is important to note that it can take up to 10 business days (after payment is received) to reinstate coverage with the insurance carriers. Some insurance carriers are faster, but, as a rule, expect the insurance carrier to take approximately 8-10 business days.
If you have not already done so, please contact the member services team for your insurance carrier. Ask them to look for coverage under your name, Social Security Number, and/or date of birth. If they are able to find you in their system, they should be able to provide you with a current member ID and plan benefit information.
If your insurance is not able to confirm active coverage, please reach out to the Vita Concierge to report the issue by email: help@vitamail.com or phone: (650) 966-1492.
Appointment During the Reinstatement Window
If you have a medical appointment scheduled prior to your when COBRA coverage is reinstated, you may want to pay your premium immediately upon your election as this will start the process of reinstating your coverage earlier.
If you keep your appointment while your coverage is not active, you may have to pay for your appointment out of pocket and then submit a claim for reimbursement after your coverage is reinstated. You may want to ask your medical provider the following questions so that you understand their billing procedures and office policies:
What do I have to pay today to keep my appointment?
Can you resubmit the claim to my insurance once my coverage is showing active?
How will you refund me any amount that I’ve overpaid?
Does this appointment require prior authorization from my insurance?
If you are comfortable with the provider’s answers, and the appointment does not require prior authorization, you may choose to keep your appointment. Please be sure to follow your provider’s recommendations on how to get your claim resubmitted once your COBRA coverage is showing active.
If you are uncomfortable with your provider’s answers, and your medical appointment is not urgent, you may want to consider rescheduling the appointment until after your COBRA coverage has been reinstated.
Prescription Needed During Reinstatement Window
You have the option to pay for your prescriptions out of pocket and then submit the claims to your insurance later once coverage is reinstated. You may want to ask your pharmacist the following questions:
What do I have to pay today to pick up my prescription?
Can you resubmit the claim to my insurance once my coverage is showing active?
How will you refund me any amount that I’ve overpaid?
Does this prescription require a new authorization from my insurance every time it is refilled?
If you are comfortable with your pharmacist’s answers, and the prescription does not need a new authorization before this refill, you can pick up your prescription. Please be sure to follow your pharmacist’s recommendations on how to get your claim resubmitted once your COBRA coverage is showing active.
Resubmitting Claims After the Fact
If your provider cannot resubmit the claim on your behalf, you will need to reach out to your insurance carrier’s Member Services department and have them confirm the next steps to process your claim.