risking a 5 day insurance gap?

March 25, 2015 5:08 PM

I would have a 5 day gap between my new job's health insurance and ending my ACA health insurance. Should I buy another month of ACA or risk the 5 day gap?

My ACA insurance starts on the 1st of the month. My job insurance won't start until the 5th. I'll have to pay in a few days to continue my insurance to cover me from April 1st to April 5th, but I'm considering canceling since it'll only be a few days. I'm very healthy. Is there anything I'm not considering? Can I use something retroactive like COBRA?

posted by inevitability to Work & Money (17 answers total)

It's likely that you can get a prorated refund when you cancel your ACA insurance, given that you will be canceling for an eligible life event, so you'll be able to get like 85% of your April payment back - ask your insurer.
posted by brainmouse at 5:20 PM on March 25, 2015 [1 favorite]

It is likely that you'll be fine during those 5 days, and health coverage sure is expensive, but the complete five-to-seven-figure shitshow of not having insurance for just one emergency hospital visit would make it impossible for any reasonable American in this day and age to recommend going without.
posted by I EAT TAPAS at 5:24 PM on March 25, 2015 [2 favorites]

I want to add that I've gone from being perfectly healthy to suddenly being in a situation that required immediate hospitalization three times in my life, and each time, the invoices totaled between $20k and $70k. Keep in mind also that if you get in an accident or have an emergent condition during those five days, you also likely will not be able to start your new job, and will have trouble getting insurance for the whole month.

Don't take the risk if you don't have to.
posted by I EAT TAPAS at 5:37 PM on March 25, 2015 [3 favorites]

You should probably get an insurance rider that will carry you for a month since you are concerned. There will be overlap, but if it gives you peace of mind, why not pay for it? Personally, I wouldn't worry about it, but I have a high tolerance for risk.
posted by zagyzebra at 5:45 PM on March 25, 2015

In a gap like this, i suddenly got a super fast onset really bad throat infection that ballooned in to me not even being able to swallow in excruciating pain, basically drooling on myself to avoid it. After a CT scan and a bunch of ridiculous stuff(it's a teaching hospital! lets run through every possible thing!) they gave me a bottle of antibiotics and a $3500+ bill.

My insurance kicked in the next monday.

The process of dealing with that stupid bill, which i started to pay off with payments that they then lost the paperwork/evidence of and sent me to collections acknowledging none of them and bla bla bla bla so much garbage has been one of the bigger hassles i've ever had to deal with. Seriously. It's a goddamn fucking disaster.

I would avoid this if i ever could, even if i had to pay some dumb amount like $200-500 that didn't feel worth it. Who knows what the hell could happen, and oh my god what a hassle.

Note that i'm a healthy as an ox, athletic person who was in their early 20s at the time and would regularly bounce off colds within 24-48 hours even if i was drinking like a fish right through them. Shit happens, yo.
posted by emptythought at 5:50 PM on March 25, 2015

Not to pile on, but the whole reason that you have health insurance when you are a generally healthy person is for the catastrophic/unpreventable/accident stuff, such as getting hit by a car -- you have to not think of it as "well, I don't take any prescription medications so this is a waste of money" but "this is the money I pay so that my life doesn't go to hell if something really terrible happens to me."
posted by andrewesque at 6:05 PM on March 25, 2015 [1 favorite]

Did you already start your new job? If yes, how long ago? I ask because not every employer will start your benefits on your first day. There may be a period before you are "eligible" for benefits.

This happened to me on my last job change. New job benefits would not start until the 1st of the month following the hire date. As a result I made sure my start date was before the 1st of the month and my last day at old job was a few days before. My insurance premium at old job was paid until the end of the month so I had no gap in coverage.

If you've already started your new job and April 5th is when the benefits kick in then I would agree with the above suggestions of paying for the 5 days coverage to be safe.
posted by eatcake at 6:06 PM on March 25, 2015

Anecdata: My husband got a new job and there was a two week gap in our insurance. That's exactly when my daughter broke her leg. Will something happen in that five day? Probably not, but with the cost of emergency treatment you're taking a real risk.
posted by Requiax at 6:39 PM on March 25, 2015 [1 favorite]

All about your personal risk management strategy. Personally, I wouldn't sweat it. The odds that something catastrophic will happen in that period of time are just... tiny. The cost of processing the paperwork will dominate the expected cost of the insurance!
posted by Mars Saxman at 6:55 PM on March 25, 2015

I personally would not risk a gap. I am also very healthy. The two worst illnesses in my life came on within 24 hours of infection and I was debilitated within mere hours after feeling the onset of symptoms. Both were chance events that could happen to anyone and had nothing to do with lifestyle or genes. The last one required a nurse coming to assist me at home / change my IV sac every few days for over a month. I was unable to walk or wash myself. Had I been anywhere without free health care I would have ended up either bankrupt or dead.
posted by partly squamous and partly rugose at 7:05 PM on March 25, 2015

This is simply a function of your tolerance for risk versus the savings. Me personally? I would first find out if I can a refund for the unused portion and if I could I would do that, or, if not, I would risk it.

I am willing to risk big money betting that you are not the first person in this situation and that the choice is not binary between paying for overlapping coverage or no coverage. I would also find out if it is possible to start your work coverage later if you cannot get a refund on your ACA.

(Or, what Mars Saxman said.)
posted by 724A at 7:22 PM on March 25, 2015

Best answer: I can't say whether you should have a gap in coverage. I can tell you that I recently cancelled my ACA insurance plan after acquiring an employer based health plan. I was surprised to find out I had to give two weeks notice to cancel the ACA plan so I had to pay the entire months premium and then they refunded the balance.
posted by blacktshirtandjeans at 7:43 PM on March 25, 2015

For what it's worth, I have allowed myself to have gaps in coverage, and I have a pre-existing condition that requires me to take medication everyday. I am a hypochondriac (not really, but generally very concerned about my health and safety) and I actually went months without insurance, opting to just pay out of pocket for generic versions of my meds when I was younger and stupider. If you're that scared, maybe you can stock up on food and spend those five days in your house not doing anything that could possibly cause an accident for you. I think of myself as pretty risk averse, but also weighing the odds here, for me I would risk the five days.

I would be a little surprised if your coverage didn't actually start on the 1st, or if when you enrolled it didn't retroactively cover the 1st of the month. I would also be surprised if you can't get ACA to cover you up until you get your new insurance. Maybe ask your HR rep or a rep from your new insurance company.
posted by AppleTurnover at 9:52 PM on March 25, 2015

I changed from ACA to retroactively-applied employer insurance and was told by the ACA insurance provider that I can get a refund of the ACA premium provided I didn't use any services during the overlap. I'm in Northern California, so I don't know if it applies in your area/state/other jurisdiction.

However, I'm still chasing that refund, though, because insurance companies are very slow with refunds. (Yet they're really fast with billing!)
posted by melvinwang at 12:01 AM on March 26, 2015

. I would be a little surprised if your coverage didn't actually start on the 1st, or if when you enrolled it didn't retroactively cover the 1st of the month.

I recently left a job where the insurance coverage ended the last day I worked, the 13th of the month. I would not be the least surprised to start at a job that did not retroactively cover me.
posted by the agents of KAOS at 2:13 AM on March 26, 2015

The odds that something catastrophic will happen in that period of time are just... tiny

Sure, you can minimize risk (maybe don't go camping in bear country over the weekend you don't have insurance), but the whole point of insurance is that you don't know in which 5 day period you'll need it.
posted by Nonsteroidal Anti-Inflammatory Drug at 6:16 AM on March 26, 2015

Response by poster: Thanks for the advice (and horror stories, haha)! I called ACA and it turns out I missed the deadline to cancel ACA for April (need 2 weeks, I never knew!), so I can't be disenrolled until May 1st. So now I'm trying to push my employer insurance coverage date until then.
posted by inevitability at 7:19 AM on March 26, 2015