Decent, reliable health insurance to fill a 3-week gap?
July 10, 2021 6:01 PM   Subscribe

My 28-year-old son graduated from a school and his very good health insurance through the school is going to end on August 20th.

He begins a job around September 15th (exact date has not been set yet). It's also not clear yet if job's (excellent) health insurance will begin on Day 1 of employment or if he has to wait.

Is there a way to get "gap" insurance for this very short period of time? He could go on the ACA but his coverage would have to begin at the beginning of September (it could start on Aug. 1st but it would be dumb to give up 20 days of excellent insurance). or he could start on Sept. 1 for the time period before his job insurance kicks in, but again that seems sort of dumb.

I've heard something about catastrophic short-term insurance but can't find reliable information about it. If you know something about this, where he could set his own dates, I'd love to hear about it. I understand it wouldn't cover pre-existing conditions or prescriptions. It would just be for an accident, ambulance, ER, etc.

I know this all seems too hysterical, but said son has had an ER visit with ambulance (shoulder), actual surgery (shoulder), and two in-office procedures under anesthesia in the past 18 months, so I can't say, "oh nothing will happen in that gap month."

Oh, and he's too old to get on parents' insurance and parents are on Medicare anyway, so that doesn't work.

posted by DMelanogaster to Health & Fitness (23 answers total) 1 user marked this as a favorite
Is he eligible for COBRA from his school's health insurance? That would be his best bet, especially as he can active it retroactively if needed.
posted by NotMyselfRightNow at 6:44 PM on July 10, 2021 [1 favorite]

Yes. Ask the school directly.

From a previous discussion:

"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."
posted by Mr.Know-it-some at 6:58 PM on July 10, 2021 [10 favorites]

Also, are you sure that his coverage ends the day of graduation? It’s not uncommon for coverage to extend to the end of the month. If that’s the case, there’s 40% of the time he needs to cover.
posted by kevinbelt at 7:00 PM on July 10, 2021 [1 favorite]

I'm guessing that kevinbelt may be right, doublecheck that.

Either way, he probably won't have any income for August and September, right? Even if he's got part-time or on-campus work, if his income is below 138% of the poverty line (something like $1400/mo) he is probably eligible for Medicaid -- unless you will be claiming him on taxes for 2021, or unless he lives in one of the remaining states (mostly in the South and interior West, of course) that didn't expand Medicaid.

That'd be ideal as it's free and will take care of him during the gap if any emergency happens.
posted by tivalasvegas at 7:11 PM on July 10, 2021

Best answer: I have never heard of people being able to get COBRA based on losing student-based insurance, by the way.
posted by tivalasvegas at 7:15 PM on July 10, 2021

Best answer: You’re not being hysterical.

I’m not surprised if his coverage ends on the 20th. NYU’s for example, also ends August 20th.

He should contact his new employer’s HR department or hiring manager to get the details about when his coverage starts.

I had a short term health insurance plan between college and graduate school. If I remember correctly, it was through United. I never needed it, but I am an anxious sort about hospital bills.
posted by umwhat at 7:28 PM on July 10, 2021

Best answer: COBRA requires employers to offer an extension of health care benefits to their employees after termination of employment. Unless your son's college health insurance is related to his employment there, COBRA is likely not an option. HOWEVER:

1) If you aren't both certain, call the school to find out the date insurance ends. Literally every health insurance policy I've had or seen goes through the end of the calendar month, so I'm surprised that his goes through August 20th, not the 31st. So do check.

2) He should call HR for his new job and ask when the insurance will start. That's HR's job, and they won't be surprised by the question.

3) The state/county in which he lives will be the determining factor, as health insurance isn't general available nationwide. X policy is usually made available in specific counties in specific states. You can all health insurance agents to ask about available policies in your county.

4) Read this article from Investopedia for The Best Short-Term Health Insurance Providers from earlier this year. See if any of those policies will be applicable where your son lives.
posted by The Wrong Kind of Cheese at 7:31 PM on July 10, 2021

Best answer: Heh, umwhat and I picked the same link. Also, since it's the weekend and you won't get to talk to a health insurance agent until at least Monday, you may want to look at ehealthinsurance and what they are showing for short-term policy quotes.
posted by The Wrong Kind of Cheese at 7:35 PM on July 10, 2021

Response by poster: umwhat, funny you should mention that NYU's goes through the 20th. Mm hm.

He is not eligible for COBRA. His insurance is school-based, not employer-based.

An ACA plan, including Medicaid, has to start on the 1st of a month, and he wants to continue his school insurance through the 20th of August, because it covers 100% of all his current doctors (he has doctors, and medications), which Medicaid will not.

I will dive into the article suggested by The Wrong Kind of Cheese! thank you.
posted by DMelanogaster at 7:39 PM on July 10, 2021

At all universities where I've been a student, insurance ended on the day that you graduated, even if it was in the middle of a month. It was never COBRA eligible. The only way that I have dealt with this is by negotiating for my new employer to cover the cost of ACA insurance during the gap. Not sure if that will work in your son's situation, but if he's still in the negotiation phase, it may be possible.
posted by twelve cent archie at 7:59 PM on July 10, 2021

Best answer: Are there ACA insurance navigators where you are? I got ACA insurance that started the same month my student insurance ended but I’m pretty sure I still had student insurance until that ended. You can have more than one insurance
posted by azalea_chant at 8:20 PM on July 10, 2021 [1 favorite]

Are you sure Medicaid won't cover his current needs? Co-pays for doctors, including specialists, are $0. And co-pays for medications, if there are any at all, range from $1-3.
posted by erattacorrige at 9:31 PM on July 10, 2021

I think if he starts his new plan on August 1, both plans will be in effect for until the school plan expires. Usually there is process of determine which insurance is primary and which is secondary.

The usual rule is that a person files their claim with their primary plan, get the Explanation of Benefits that tell what that plan pays and the file a claim with the EOB attached with the secondary insurance which will then pay according to their own rules.

I don't know the rules about which one would be primary but if it the older plan (maybe?) then everything should be seamless. If the new plan is deemed primary, your son will still have coverage, it would just involve more paperwork.
posted by metahawk at 12:58 AM on July 11, 2021 [1 favorite]

Response by poster: Well, I just found out that NY does not allow the sales of short-term insurance policies. Gah. Thanks anyway.
posted by DMelanogaster at 5:45 AM on July 11, 2021

Someone I know (going in the opposite direction) went from job's health insurance -> ACA insurance plan for 2 months -> school health insurance. It looks like an ACA plan may be the only option for your son.
posted by oceano at 6:34 AM on July 11, 2021 [1 favorite]

Your son is probably eligible for Medicaid. It looks like that coverage is retroactive for 90 days for unpaid medical bills, so if your son incurs bills before the coverage officially takes effect he should just not pay the bills and submit them to Medicaid for payment.

I also found this thing that allows you to extend the young adult coverage on your plan to age 29 if the young adult loses coverage on their own (or if they age out). Eligibility is determined by aging out or qualifying events. It's retroactive for young adults who age out, but it says it's prospective for young adults who encounter other qualifying events (like your son). However it is worth calling your insurance plan to ask them if you start the application process now is it possible to get the coverage to start as soon as his plan ends, or are you not allowed to apply until his plan is over.
posted by Anonymous at 7:02 AM on July 11, 2021

Best answer: If you sign him up for Medicaid for august and September, it won’t cancel out his student insurance. Medicaid is always secondary to other insurance (I believe the term is “payer of last resort”). If nothing else it would act as a safety net for the no income gap, maybe less ideal than your original hopes but far better than nothing.
posted by mismatched at 9:10 AM on July 11, 2021

Response by poster: Medicaid won't cover his current doctors because they don't accept Medicaid. But that's okay -- I'm just looking for "catastrophic." The BIG REVELATION here, that I should have thought of, is that you can have an ACA plan (including Medicaid) AND the student insurance at the same time!! duh.

I will get on this tomorrow, since he only has until the 15th of this month to sign up for the ACA plans beginning August 1st!
posted by DMelanogaster at 12:37 PM on July 11, 2021

Response by poster: schroedinger, I believe I said that his father and I are on Medicare, and you can't get Medicare as a child of a Medicare recipient, regardless of age.
posted by DMelanogaster at 12:48 PM on July 11, 2021

My comment was talking about Medicaid, not Medicare. You absolutely can get Medicaid if your parents are on Medicare. They are different things. Also Medicaid would be significantly less expensive than an ACA plan and I don't believe you can get an ACA plan if you already have insurance.
posted by Anonymous at 4:50 PM on July 11, 2021

Response by poster: schroedinger, I was referring to this part of your post: "I also found this thing that allows you to extend the young adult coverage on your plan to age 29 if the young adult loses coverage on their own (or if they age out)."

But, as for Medicaid -- I thought that was now part of ACA, at least in NYC. If you go to the ACA website and put in zero income, you're directed to Medicaid (so I guess that officially that's not an "ACA plan"?)
posted by DMelanogaster at 5:24 AM on July 12, 2021

Response by poster: Well, I did it! Signed son up for health insurance on the NY State Marketplace. Not Medicaid -- I used his projected 2021 income and got a regular policy. Thanks for all the advice, it got me through this!!
posted by DMelanogaster at 7:14 AM on July 12, 2021

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