Options for family between health insurance coverage
April 4, 2024 6:51 AM Subscribe
Options for family between health insurance coverage
COBRA/Medical Insurance Question - Our household is about to be between medical insurance. Family of 4 with two young kids that often need drs visits. My wife had to stop working the minimum for health insurance because we lost our nanny and havent found a replacement. Therefore our health insurance (and dental) coverage is ending tomorrow and my employer's insurance coverage doesnt start until the first of the following month which will be May 1st.
Our option is to have COBRA for 4 weeks in between but it will cost around $4k.
Are there any alternatives or market insurance plans that would be more cost effective for this 4 week gap for any catastrophic medical events? Or do we just need to spend $4k for COBRA coverage for the 4 week gap?
COBRA/Medical Insurance Question - Our household is about to be between medical insurance. Family of 4 with two young kids that often need drs visits. My wife had to stop working the minimum for health insurance because we lost our nanny and havent found a replacement. Therefore our health insurance (and dental) coverage is ending tomorrow and my employer's insurance coverage doesnt start until the first of the following month which will be May 1st.
Our option is to have COBRA for 4 weeks in between but it will cost around $4k.
Are there any alternatives or market insurance plans that would be more cost effective for this 4 week gap for any catastrophic medical events? Or do we just need to spend $4k for COBRA coverage for the 4 week gap?
Best answer: You can sign up for COBRA retroactively within 60 days of loss of your first employer coverage, so if you're not able to get your new employer's insurance before May 1, you could delay any appointments until then and use the retroactively coverage option in case of an emergency. If you don't have an emergency, then you wouldn't need to pay.
posted by Theiform at 7:26 AM on April 4 [4 favorites]
posted by Theiform at 7:26 AM on April 4 [4 favorites]
Agree with phunniemee, at my company in IL if your employment terminates after the first of the month, you should be covered for that entire month. If the employer paid some of your family's insurance premium, it would have been paid on the first of the month for all of April. In that case, you would still owe your portion for the remainder of April, but it shouldn't go up during the month.
If you have verified your coverage actually ends on April 5, then I agree with Theiform, that you have at least 45 days (might be 60) and can retroactively sign up for Cobra, so you could put that off if you can avoid dr visits until May 1.
posted by Glinn at 10:14 AM on April 4
If you have verified your coverage actually ends on April 5, then I agree with Theiform, that you have at least 45 days (might be 60) and can retroactively sign up for Cobra, so you could put that off if you can avoid dr visits until May 1.
posted by Glinn at 10:14 AM on April 4
Response by poster: >>>The timing of this doesn't make sense to me. Are you with a new employer?
No, I have been with my employer for 8 months
>>>If so, then okay this may be true. But if you've been with your employer for a while, your spouse losing coverage is a qualifying event for you, which should qualify you for coverage beginning immediately upon the end date of your spouse's coverage.
My employer said they can only start health plans at the first of every month. they also need a letter from my wife's insurance or employer stating/proving that coverage was ending. My wife's employer said they can only provide that statement when coverage has ended and cobra is beginning.
>>>It's pretty common for employer plans to cover you until the last day of the month. Are you very sure that your spouse's plan is ending mid month? On April 5th? It's possible, but it's unusual.
She went onto a 4 week personal leave in order to keep our insurance for one more month while we were searching for a new nanny in case we could find someone.
>>>Your employer may be thinking that your family is covered until April 30 and so slated you in for a May 1 start date with an April 30 QLE. Make sure your employer understands that April 5 is your QLE, and see what your coverage option is.
In my personal experience of employer sponsored health insurance, you should be eligible to start your own coverage with your own employer April 6.
That's also what we were expecting but they said it can only start on the first of every month. It's a municipality.
posted by Reasonably Everything Happens at 10:45 AM on April 4
No, I have been with my employer for 8 months
>>>If so, then okay this may be true. But if you've been with your employer for a while, your spouse losing coverage is a qualifying event for you, which should qualify you for coverage beginning immediately upon the end date of your spouse's coverage.
My employer said they can only start health plans at the first of every month. they also need a letter from my wife's insurance or employer stating/proving that coverage was ending. My wife's employer said they can only provide that statement when coverage has ended and cobra is beginning.
>>>It's pretty common for employer plans to cover you until the last day of the month. Are you very sure that your spouse's plan is ending mid month? On April 5th? It's possible, but it's unusual.
She went onto a 4 week personal leave in order to keep our insurance for one more month while we were searching for a new nanny in case we could find someone.
>>>Your employer may be thinking that your family is covered until April 30 and so slated you in for a May 1 start date with an April 30 QLE. Make sure your employer understands that April 5 is your QLE, and see what your coverage option is.
In my personal experience of employer sponsored health insurance, you should be eligible to start your own coverage with your own employer April 6.
That's also what we were expecting but they said it can only start on the first of every month. It's a municipality.
posted by Reasonably Everything Happens at 10:45 AM on April 4
Response by poster: Edit to add to original post:
We found a comment online that you can retroactivate COBRA for 2 months so the best thing is to not enroll in it yet but wait to see if there is an expensive medical event first and then activate if that happens. But just pay out of pocket if we need a drs visit or walk in care etc. is this true of all COBRA?
posted by Reasonably Everything Happens at 10:45 AM on April 4
We found a comment online that you can retroactivate COBRA for 2 months so the best thing is to not enroll in it yet but wait to see if there is an expensive medical event first and then activate if that happens. But just pay out of pocket if we need a drs visit or walk in care etc. is this true of all COBRA?
posted by Reasonably Everything Happens at 10:45 AM on April 4
Best answer: Yes, your situation is perfect for electing COBRA retroactively if you need it, and that is an option for essentially all employer health plans. See question 8 in this Department of Labor document. Has your wife's job given her the COBRA information yet? This all should be outlined in those documents, along with the official end date of your coverage under her group plan.
posted by mjcon at 11:57 AM on April 4
posted by mjcon at 11:57 AM on April 4
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Are you with a new employer? If so, then okay this may be true. But if you've been with your employer for a while, your spouse losing coverage is a qualifying event for you, which should qualify you for coverage beginning immediately upon the end date of your spouse's coverage.
It's pretty common for employer plans to cover you until the last day of the month. Are you very sure that your spouse's plan is ending mid month? On April 5th? It's possible, but it's unusual.
Your employer may be thinking that your family is covered until April 30 and so slated you in for a May 1 start date with an April 30 QLE. Make sure your employer understands that April 5 is your QLE, and see what your coverage option is.
In my personal experience of employer sponsored health insurance, you should be eligible to start your own coverage with your own employer April 6.
posted by phunniemee at 7:01 AM on April 4 [4 favorites]