If you qualify for Medicare based on age or disability, whether you can have both COBRA and Medicare depends on which you have first.

  • If you already have COBRA when you enroll in Medicare, your COBRA coverage usually ends on the date you enroll in Medicare. If you have COBRA and become Medicare-eligible, you should enroll in Part B immediately because you are not entitled to a Special Enrollment Period (SEP) when COBRA ends. Your spouse and dependents may keep COBRA for up to 36 months, regardless of whether you enroll in Medicare during that time.

    Note:You may also be able to keep COBRA coverage once you get Medicare for services that Medicare does not cover. For example, if you have COBRA dental insurance, the insurance company that provides your COBRA coverage may allow you to drop your medical coverage but keep paying a premium for the dental coverage for as long as you are entitled to COBRA.

    • If you already have Medicare when you become eligible for COBRA, you must be allowed to enroll in COBRA. Unless you qualify for Medicare because you have End-Stage Renal Disease (ESRD), Medicare acts as the primary payer and COBRA as the secondary payer, so you should stay enrolled in Medicare Part B. You may wish to take COBRA if you have very high medical expenses and your COBRA plan offers you generous extra benefits, like prescription drug coverage.

    If you are eligible for Medicare because you have ESRD, there is a period of time when your employer group health plan will pay first and Medicare will pay second. This is called the 30-month coordination period. If you have COBRA during this time, COBRA will be your primary insurance during your 30-month coordination period. If your COBRA coverage ends before the 30 months have passed, Medicare becomes primary. If you still have COBRA when the 30-month coordination period ends, Medicare will pay first and your COBRA coverage may end (check with your State Department of Insurance for details on your state laws regarding COBRA coverage).