Use COBRA Coverage with your Alma Provider

What is COBRA coverage?

COBRA is a temporary form of health insurance you can use when you lose the insurance you had through an employer. 

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act, a federal law created in 1985. It provides individuals who experience a qualifying event with the option to continue their current health insurance coverage for a limited period, thereby avoiding gaps in coverage. 

If you already see an Alma provider and your original plan covered your sessions in-network, COBRA allows you to continue care with the same in-network benefits, as long as you enroll in COBRA with the same insurance company.

How do I get COBRA coverage?

You can enroll in COBRA if all three of these conditions are true:

1. Your employer’s group health plan offers COBRA
2. You experience a qualifying event
3. You are a qualified beneficiary under that event

Qualifying Events

Your employer may provide you with information on how to enroll in COBRA to continue your healthcare coverage. You may qualify for COBRA if you experience one of the qualifying events:

• Job loss
• Reduced work hours
• Divorce or legal separation
• Death of a spouse
• Moving
• Marriage
• Having or adopting a child

Qualifying Beneficiaries 

Qualified beneficiaries include:

• The employee who has coverage under the plan, including active employees, terminated employees, and retirees 
• Covered employee’s spouse and dependent children
• Children adopted or born during COBRA coverage
• Self-employed individuals and independent contractors, and their employees
• Directors of the employer; and, for public sector group health plans, political appointees and elected officials

How do I use my COBRA coverage at Alma?

If you enroll in COBRA and want to continue care with your Alma provider, follow these steps:

1. Get your COBRA receipt showing you paid your premium. It must:
   • Be an official COBRA receipt (not a bank statement)
   • Show the full premium amount paid
   • Show the coverage period
2. Send your COBRA receipt to Alma by contacting us using the Help button on the bottom-right corner of the Support Center.
3. Alma’s eligibility team will verify your coverage so you can continue sessions without interruption.
4. Send Alma a new COBRA receipt every month to confirm that your coverage is still active.

Note: contact us as soon as you have your COBRA receipt. This helps us to verify your continuation of coverage as soon as possible and minimize disruptions in care.

If you elected the same benefits as your COBRA benefits, your payment responsibility will likely stay the same.

If your insurance company denies your Alma session claim or changes your cost, you are responsible for the updated amount. If this happens, contact your Insurance company for benefit details.

How is COBRA different from regular commercial insurance?

Employers pay a lower group rate premium for the insurance they provide to their employees. When you lose that coverage, COBRA allows you to continue with the same insurance plan you had. Instead of switching to a more expensive individual plan, you pay the full group rate yourself.

For example:

• If your employer provides Aetna, they pay a group rate that is lower than what individuals would pay privately for the same coverage.
• If you leave that employer, voluntarily or involuntarily, you may qualify for COBRA.
• When you enroll, you still have Aetna insurance with the same coverage and provider network.
• Since your previous employer will no longer be paying the premium, you will pay the full premium yourself, but at the group rate instead of a higher private rate.

COBRA may be a smart choice if:

• You want to keep the same provider
• You are close to meeting your deductible
• You need ongoing care without interruptions

To decide if COBRA is right for you, contact your insurance company by using the number listed on your insurance card or contact a COBRA representative.

How long can I use COBRA coverage?

Most COBRA coverage lasts 18 months, but certain situations may allow for extensions of up to 36 months. Because COBRA is temporary, you will need to submit a new COBRA receipt every month to avoid disruptions to verify your coverage.