Common Health Insurance Gaps and How to Fill Them

Health insurance is a necessity. Without it, you run the risk of having to pay for emergency medical expenses out of pocket, which can lead to years of debt or even bankruptcy.

If you’d like to secure your financial future, you need to have adequate health insurance. But unfortunately, having health insurance isn’t always a simple, linear process.

Health insurance gaps are those events or circumstances where you aren’t covered for a period of time, or where you are outside of insurance coverage. In these instances, it’s better not to take the risk of living uninsured.

The thing with emergencies is that you never know when they will occur. If you’d like to avoid gaps in your health care coverage, then keep reading to understand what type of gaps exist and how to fill them so you’re always protected. 

What Is a Health Insurance Gap?

A gap in your health insurance coverage could occur when switching from one insurance plan to the next. From the time that your current plan ends to the time that the new plan begins would be a gap.

If you had an emergency during this time or needed to seek medical attention, you wouldn’t be covered. You would have to pay for this out of pocket. 

As a result, it’s extremely important that you plan ahead when you know you’re going to be switching providers or plans to ensure you don’t have any gaps in your coverage. Though if you can’t avoid a gap, you can receive temporary or supplemental insurance. 

Common Health Insurance Gaps

Most Americans receive health insurance through an employer-sponsored plan. A common gap in insurance would be switching from one employer to another. You may experience a gap before your new health plan kicks in.

Although many people switching jobs will begin their new role immediately after ending at their previous company, some decide to take a break. This could before vacation, moving to a new town or state, or taking some time to yourself.

A short gap in health insurance is considered any amount of time under three months. If you anticipate a gap in your coverage, make sure to research options well in advance.

When choosing an insurance policy for temporary or supplemental reasons, you’ll want to know how soon coverage kicks in. Some policies require a waiting period before benefits actually begin. 

Other gaps in insurance can include events or circumstances outside of your current coverage plan. While events during domestic travel are often included in health insurance plans, international travel usually isn’t. 

Receiving vaccines specifically for travel to certain regions may also not be covered, since they aren’t medically necessary. Alternative therapies may or may not be covered, such as visiting a chiropractor or receiving a massage. 

Best Ways to Fill Gaps

So once you’ve identified potential gaps in your coverage, how can you fill them up for peace of mind. Here are the most common methods.

Short Term or Supplemental Plan

Depending on your situation and the length of your healthcare gap, you may be able to get a short-term or supplemental insurance plan.

You can shop around for short-term plans which typically last any length of time under a year. The benefit of these plans is that they are affordable, provide immediate coverage, and can begin and stop at any time without penalties.

The downside of short-term plans is that they aren’t regulated by the Affordable Care Act. This means that they can vary wildly in what they offer and what they don’t. 

They typically don’t cover preexisting conditions, maternity care, preventative care, or prescriptions. These plans are intended to cover the basics, such as emergencies, during gaps in your primary plan.

Those with Medicare insurance may be eligible for Medicare supplemental insurance. These are separate policies from your Medicare plan but may cover more costs associated with your healthcare, such as copays, deductibles, and more.

Since more and more people are joining Medicare every day, this is a good option to be aware of. 

Spouse’s or Parent’s Plan

If you are leaving your employer’s plan, you may be eligible to hop onto your spouse’s employer plan. Or, if you’re under the age of 26, you may still be able to join your parent’s health insurance plan. 

This can be an affordable option if the relative is willing to add you to the plan. 

COBRA Coverage

COBRA is another popular and highly effective option for temporary coverage. If you leave your employer, you will still be able to maintain the current health insurance plan for a period of time, which could be up to three years.

However, there are limited situations that will allow you to apply. For starters, your company has to offer it. This means that they have 20 or more employees and have chosen to offer it.

To qualify, you’ll have to either have left your job, been fired, have your hours reduced and benefits removed, or experiences a divorce. 

The only downside is the high price associated with a COBRA plan. It can be a great short-term option but may be prohibitive for many. 

Public Exchange

You may be able to enroll for health insurance through the public marketplace during open enrollment. The only issue is that your gap would need to begin on the first of the year since there are specific timelines regarding open enrollment.

If you have the option of choosing when to take your gap, such as exactly when you plan to leave your job, you can arrange for this to work out.

Otherwise, specific qualifying events may allow you to enroll outside of the normal timeline. If you turn 26 and no longer qualify for your parent’s plan, you can enroll at any time.

Or if you get married, divorced, have a baby, or experience a death in the family, you can change or start a new plan. There are other qualifying events as well, so be sure to look into the requirements on the health insurance marketplace.

Don’t Take the Risk, Fill the Gap

With so many options available, it doesn’t make sense to risk not having coverage, even for a few days. Anything could happen, such as a car accident, a sports injury, or a stroke.

And with the rising cost of medical care, a medical emergency can derail your entire future. If you ever anticipate health insurance gaps, take care of them as soon as possible.

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