Minding a health insurance gap

May 25, 2017 1:22 PM

I have a short gap in health coverage (5 days) coming up, and trying to figure out the best way to handle it.

Uneducated health care consumer here.

I just got a new job (yay) that starts on 6/5. My previous health plan ends on 5/31, and new health plan starts on 6/5.

I have the option of getting COBRA insurance, but the premium would be $700+ and I would like to save the money if possible.

If I understand correctly, I have the ability within the next thirty days to apply for COBRA and have it retroactively applied, should anything calamitous happen during that gap.

I'm almost inclined not to sign up for COBRA, with worst case scenario meaning I retroactively sign up if anything bad happens.

Question: if I decide to skip having coverage for those five days, and nothing bad happens and I end up never signing up for COBRA before my new plan kicks in on 6/5, are there any potential long term repercussions? (Due to having a gap between plans)

Wondering if I could get advice on other options as well -- what do people typically do in these situations? If it really makes sense to get some sort of coverage for those five days, what are some cheaper options for short term coverage?

Fwiw, I will be on vacation in Puerto Rico for those five days...

Thank you!

posted by fishhouses to Health & Fitness (13 answers total)

Contact the new company's plan administrator? They should be able to speak to any issues with coverage gaps.
posted by amanda at 1:26 PM on May 25, 2017

No, you're fine. Even back in the dark ages a 5 day gap in coverage didn't trigger the preexisting condition/continuous coverage thing.

If something happens and you do end up having a pricey healthcare issue in those five days, then yes you can retroactively engage the COBRA coverage.

So good news: you're fine! This is not a thing you need to be concerned about. I personally am extremely risk averse when it comes to health insurance, and back in 2012 I had a gap of a month and a half. No one set the dogs on me. You're totally fine.
posted by phunniemee at 1:27 PM on May 25, 2017 [8 favorites]

You're fine. I quit a job in March to start a new job in mid-April, but the new job had a 42-day wait before health insurance kicked in. I know, WTF. So I was without insurance for about two months (new insurance starts tomorrow, woo! as long as we can make it til midnight tonight we're golden!)

So I had to research this to see if there would be a problem (I mean, besides not having health insurance for two freaking months) and from what I can tell, there's no problem with a short gap caused by switching jobs.

Yes, you can apply for coverage via COBRA retroactively if you end up needing it, and no it shouldn't cause you any problems because of the gap. As long as your gap is less than 3 months it won't be held against you according to current healthcare law.
posted by rabbitrabbit at 1:31 PM on May 25, 2017

I had a one-month insurance gap, during which I fell down the stairs and broke my foot, necessitating an emergency room visit. I was really glad that something more serious didn't happen.

Make very sure that the COBRA coverage can be instituted retroactively. I don't doubt that people here know what they're talking about, but make sure you have it in writing.
posted by FencingGal at 1:36 PM on May 25, 2017 [1 favorite]

5 days is fine. As everyone is saying, if you get hit by a falling anvil at the same time that your pants fall down, you could elect COBRA retroactively. It's good advice to check with the benefits administrator at the job you're leaving to confirm via email, but they shouldn't bat an eye at the question.

To pile on the anecdata, but I did exactly this leaving a job and was uninsured for about a month before the new coverage kicked in. All totally fine.
posted by superfluousm at 1:46 PM on May 25, 2017

Annecdata: I have never even received the COBRA paperwork less than a week after leaving a job.
posted by Kriesa at 1:49 PM on May 25, 2017 [4 favorites]

I agree with the above answerers, and helping folks with health insurance is my day job (yay, I'm on Metafilter & not slacking!)

Double-check on your COBRA, but I've never seen a situation where you couldn't retroactively apply for at least 30 days after coverage ended. But yeah, make sure you confirm it by taking another look at the paperwork.

You also might want to check to make sure your policy does cover any emergency you might have in Puerto Rico. I'm assuming that it would be the same as if you got in a car accident in the next state over but you know what they say about assumptions. You might also just price out a short-term travel policy, if you're a conservative type (though I never have, personally, and I do a decent amount of international travel).
posted by tivalasvegas at 1:53 PM on May 25, 2017

The explanation of the 60 day rule from the Center for Medicare and Medicaid Services: "Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage."

And if you don't trust them, it was discussed on some other website.
posted by Mr.Know-it-some at 1:53 PM on May 25, 2017 [1 favorite]

Oh good, I thought it was 60 days but now I don't even have to look it up.
posted by tivalasvegas at 1:56 PM on May 25, 2017

Hmm, and per that CMS factsheet, it looks like it's 60 days from the later of the date coverage ended OR the date you received the notice, so if you haven't gotten it yet (a la Kriesa's comment), you may have even longer to elect than you think.

Q14: How do I elect COBRA?

Qualified beneficiaries must notify the plan administer of their election according to the instructions laid out in the election notice. Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage. This period is measured from the later of the date of the qualifying event or the date the COBRA election notice is provided. COBRA coverage is retroactive if elected and paid for by the qualified beneficiary.

posted by tivalasvegas at 2:00 PM on May 25, 2017

What I usually tell people who will have a less than 60 day gap:

1. Fill out the COBRA paperwork
2. Put it and a check for the premiums in an addressed envelope with a stamp.
3. Put the envelope somewhere obvious.
4. Tell significant other / friend: "If I'm in the hospital, mail that envelope."
5. Once you get new coverage, shred the envelope.

If your gap will be more than 60 days you should probably enroll or find other coverage for the time.
posted by magnetsphere at 3:43 PM on May 25, 2017 [18 favorites]

When I started a new job in the middle of June last year, the new employer's plan covered all of June. I know this because the certificate of health coverage they sent at tax time said so.

(Note: this is just 'paper' coverage. I'm sure claiming before my start date wouldn't have worked!)
posted by monotreme at 10:26 PM on May 26, 2017

Not only do you have 60 days to sign up for COBRA, you have another 45 days before you have to make your first payment.

However, if you have a gap in coverage of three continuous months, you may be subject to the Obamacare penalty pro-rated for the length of your gap.
posted by JackFlash at 11:03 AM on May 27, 2017