Health Insurance Gap

[dayman]

I am changing jobs Jan 1. At new job, I won't be eligible for health insurance until 30 days have passed. My understanding of the best strategy is as follows:

- Obtain forms to apply for COBRA from current employer, but don't actually apply right away
- Plan on using no healthcare in January
- If no healthcare used in January, don't submit COBRA and just proceed with new coverage
- If emergency care needed in January, apply for COBRA after the fact, pay premium and we'll be covered retroactively

Do I have this right? Do I need to request forms from current employer, or will the documents to apply for COBRA be sent automatically? Does this create an issue down the line if we were technically uninsured for a month? Thanks for any help.

[billy]

Apply for cobra, do not pay (the bill wont be due for like 45 days). If you end up needing insurance, you will have to pay for cobra for the whole time (jan1- the day your new insurance kicks in). If you are lucky and dont, just tell cobra sorry you ended up deciding not to use it/got coverage elsewhere and never pay. If god forbid you were in a coma/accident/whatever and never applied beforehand, it may be hard for your family to figure out that you needed to apply.

[Peds]

No definitely do not apply. It's retroactive so there's literally nothing you have to do.

[billy]

Peds I disagree bc he's only uncovered for 30 days, so he wont have to pay. Just don't send in a check when the bill comes. I've done this between jobs myself. COBRA gets canceled when you don't pay. So if he applies and doesn't use it, there is no medical services charged to COBRA, and the government wont come after you for "unpaid" coverage time. So there is no harm to OP in applying since he will only be uninsured for less time than it takes for the bill to be due.

OP if you do not apply and are saving it for in case you need it, at least fill out/sign the form and have someone (wife, parent) know where it is so that if you do end up in a coma or some extreme emergency on day 29 that lasts past day 59, someone can send in the application for you before your eligibility expires.

For reference:
https://www.coverage.com/insurance/h...bra-insurance/
https://www.verywellhealth.com/late-...at-now-1738821

[dayman]

Thanks billy and peds. In years past I remember a form around tax time, where I had to attest to having health insurance each month or pay a penalty. Is that no longer an issue?

[Tim]

The penalty was eliminated.
The government does not provide cobra coverage. All cobra is retroactive to the first day you left a previous employers plan.

The question is the collection practices. You sign up for coverage, do they cancel and turn it over to collections? Individual procedure choice.
The coverage will be exactly as the prior plan.
This is important if changing locations and you have in network and out of network. New location, you might have only ER coverage.

We had an event, signed up, paid the back due premiums and had coverage, after the fact.

The unsettling piece was the $20k bill that thankfully disappeared after the delayed Cobra.

It works on the delayed filing.

[Scott at MD Financial Services]

I am no health insurance expert but I seem to recall that if you hop from one plan to another without the cobra no big deal if there is not a claim during the first year or so but the back of my mind there is something about a break in coverage, I think they called it 'continuation of coverage' which leads to no pre-ex but a break does. Again not an expert, heck not even proficient in it as we have not had a health policy being brokered through our firm in 20 years but you might confirm that there will be no pre-ex if you join a health plan while not having coverage the prior month to joining.

[dayman]

I am no health insurance expert but I seem to recall that if you hop from one plan to another without the cobra no big deal if there is not a claim during the first year or so but the back of my mind there is something about a break in coverage, I think they called it 'continuation of coverage' which leads to no pre-ex but a break does. Again not an expert, heck not even proficient in it as we have not had a health policy being brokered through our firm in 20 years but you might confirm that there will be no pre-ex if you join a health plan while not having coverage the prior month to joining.

Thanks, this is the kind of nuance I am also unsure of. This may be a question I need to directly ask the new insurer.

A few articles seem to indicate that a "significant break" in coverage, defined as greater than 63 days, is the issue here. So I may be fine with a 30 day gap.

[Hatton]

How much is the 30 day premium?

[spiritrider]

Just because you can do something does not mean you should do something.

It doesn't matter how many times you state it, Peds is correct and you are not as evidenced by your own workaround to your infinitesimal probability that your are in a coma exactly when you need to apply for COBRA. There is this little thing called perspective. Not to mention that precedence has been established that concerned family members and even medical providers can apply for COBRA for incapacitated individuals.

In the OP's circumstances there is absolutely no good reason to apply for COBRA until it has been 45 - 50 days after you received the COBRA packet and pay no earlier than 30 -35 days after enrollment. The probability that something delays the start of health insurance is several orders of magnitude greater than your infinitesimal coma event. Electing early permanently limits your options.

Apply for cobra, do not pay (the bill wont be due for like 45 days).
...
If god forbid you were in a coma/accident/whatever and never applied beforehand, it may be hard for your family to figure out that you needed to apply.

PedsOP if you do not apply and are saving it for in case you need it, at least fill out/sign the form and have someone (wife, parent) know where it is so that if you do end up in a coma or some extreme emergency on day 29 that lasts past day 59, someone can send in the application for you before your eligibility expires.

Peds I disagree bc he's only uncovered for 30 days, so he wont have to pay. Just don't send in a check when the bill comes. I've done this between jobs myself. COBRA gets canceled when you don't pay.

Just because you can do something does not mean you should do something.

[spiritrider]

Thanks billy and peds. In years past I remember a form around tax time, where I had to attest to having health insurance each month or pay a penalty. Is that no longer an issue?

The ObamaCare penalty only applied to gaps of >= 3 months and as pointed out by Tim, the penalty has been eliminated (at least for now).

A few articles seem to indicate that a "significant break" in coverage, defined as greater than 63 days, is the issue here. So I may be fine with a 30 day gap.

The 63-day break in coverage applied to pre-existing conditions. Obamacare prohibits denial of or higher rates for coverage with pre-existing conditions. Not to mention, if/when you elect COBRA coverage, it is fully retroactive. You are treated as if you had coverage the entire time.

[Tim]

A gap will not impact the employer provided health insurance plan. The risk is a permanent disability and you don't get the employer plan.
Funny thing happens if you are in a coma. The signed election can be faxed in by a relative. We actually signed the form in advance. Did not need it, they took the verbal election over the phone. Then they transferred the cover to a different plan due the the change of address. This cannot be done in advance. The plans are registered by state and each has a separate processing center. If you are in a coma, make sure the POA's are in place. No benefit in signing up in advance. Two month's bills blah blah that accomplish nothing from a coverage standpoint.