How to Avoid Lapses in Health Insurance Coverage
While nobody could have predicted the Covid-19 pandemic, businesses have been adjusting since its appearance. If you're worried about your healthcare while looking for new work, there are several ways to make sure you get the proper coverage to enable you to fill that gaps in your health insurance coverage.
First of all, confirm the expiry date of your health insurance from your employer if you have a work cover. Your coverage may end immediately you leave the job, or last until the end of the month, or possibly even cover you for a few months if you were laid off. This way, you'll have a clear idea of what you need to bridge that health insurance gap.
Five Ways to Avoid Lapses In Health Insurance Coverage
Here is a compilation list of health insurance options to consider if you're in between jobs and the pros and cons of each.
1. Short Term Health Insurance
A short-term health plan is an affordable solution if you need individual health insurance coverage for a sudden medical emergency. It covers
- Doctor's appointments
- Hospitalization
- Emergency room visits, and
- Ambulance services
However, it doesn’t cover maternity care, preventative care, prescriptions, mental health care, or pre-existing conditions.
You can apply for short-term health insurance at any time and enjoy some immediate benefits within 24 hours. This option is great if you're in general good health, but it can hurt your budget because it has high out-of-pocket costs. Note that some states don't allow for short-term plans, so check if this option is available in your area.
2. COBRA
The 1996 Consolidated Omnibus Budget Reconciliation Act (COBRA) made it possible for people to keep their health insurance benefits from their employers if they lost their jobs due to certain conditions, such as;
- Getting fired or quitting
- Having work hours reduced
- Divorcing your spouse
- If a child stops being a dependent, or
- When the covered employee dies
Only companies with more than 20 employees (both full-time and part-time) can offer COBRA, extending health insurance coverage for up to 18 months. However, your employer no longer contributes to the premiums, so it can ultimately cost a lot more than you expect because you pay the full amount plus the administration costs.
Essentially the coverage offered by your previous employer stays the same, but the costs shift to you.
3. The ACA Health Insurance Marketplace
The Affordable Care Act (ACA) offers a range of medical plans during the yearly open enrollment period. However, if you lose your employer-based health insurance, you qualify for coverage through a special enrollment period (SEP). The SEP gives you 60 days to find an alternative health insurance plan. Special enrollment plans are classified according to different insurer-subscriber pay ratios:
Tiers |
Insurer (% of average costs) |
Subscriber (% average of costs) |
Bronze |
60 |
40 |
Silver |
70 |
30 |
Gold |
80 |
20 |
Platinum |
90 |
10 |
The Bronze plan has the highest deductibles and lowest premiums, while the Platinum plan has the highest premiums but lowest deductibles. These plans also offer subsidies depending on your income and location, and they cover all health care services.
Unfortunately, if you don't qualify for the government subsidies, the premiums can skyrocket. Also, the benefits take a little time to kick in, making your need for immediate health coverage options unfavorable.
4. Medicaid
Medicaid health insurance offers the best solutions to avoid lapses in health insurance coverage. All Medicaid plans cover family planning, home health care, inpatient and outpatient fare, pediatric care, rural health clinics, ambulance transportation, and lots more services. It's also great for people with low incomes, pregnant women, and people living with disabilities.
You can apply for Medicaid at any time, and it offers consumer protection and low out-of-pocket costs. Its main drawback is that you may struggle to find doctors who accept Medicaid in your area if your state hasn't embraced the Medicaid program. It is also limited to specific income brackets, so you can’t qualify if you earn slightly more than the Medicaid threshold.
5. Spouse Health Plan
It's generally difficult to change your health insurance plan outside of the open enrollment period. Job loss can happen at any time, or major events like having a new baby or getting married. These events trigger a special enrollment period during which your spouse can add you to their insurance plan.
Your spouse simply needs to speak to their employer and see what policy options are available. This can be a quick and easy process and tends to be cheaper than COBRA plans, but it's best to compare what options are available in the individual health insurance market too.
Bonus: Children's Health Insurance Program (CHIP)
If you're facing a gap in your individual health insurance, you don't qualify for Medicaid, but you need health coverage for your children; the Children's Health Insurance Program (CHIP) may be just what you need.
CHIP offers coverage for routine checkups, prescriptions, immunizations, dental and eye care, inpatient and outpatient care, emergency care, and lab and x-ray services for your children. Premiums vary from state to state, but CHIP is generally a very affordable solution for families facing a lapse in their insurance coverage.
How to Choose the Right Health Insurance Coverage
With so many alternatives available, the smart move is to compare quotes from different health insurance providers to see what best fits your situation. Don't wait for an open enrollment period to sign up for health insurance. Avoid lapses in health insurance coverage by going to www.healthplans.com to compare health insurance coverage prices so you can pay for the coverage you want anywhere across the US.