How to File a COBRA Insurance Claim

Filing a COBRA insurance claim is similar to filing a claim with most health insurance plans.

How Do You File?

Your doctor or the hospital where you had the service done will file most claims electronically. However, you will want to check on this and not depend on them doing so in the event that filing the claim is left up to you. If you don’t hear anything regarding your benefits within one month of the treatment date, you should follow up on your claim and confirm that is was properly filed by your doctor or hospital.

If you have to file the claim yourself, you should file the claim for benefits as soon as possible because most health plans have deadlines, which can vary.

All health plans are required to provide information about how to receive benefits and how to file a claim for those benefits. You can find the details for filing claims in the written procedures or on your health plan’s website under the "Summary Plan Description." Your health plan’s website can be found on your insurance ID card.

Filing a COBRA insurance claim is similar to filing a claim under the COBRA alternative plan and several other health insurance plans. More information on plans and their prices can be found at COBRAinsurance.com, but you will have to register on the website to access that information.

What if You're Denied?

Your plan has 90 days from the date when you file the claim for benefits to notify you in writing of your denial for benefits. This notification needs to state the reasons for the denial and provide any other relevant information regarding your claim. Once you receive the notice, the plan will inform you of the procedures to appeal the denial of your claim. You will have 60 days to make the appeal for benefits and your claim, and you should receive a decision within 60 days of your appeal.

Contact your plan administrator for questions or for more information about filing your claim.

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