stop-gap Insurance

By Dev Latest Reply 2011-03-21 16:36:18 -0500
Started 2011-03-21 15:00:34 -0500

Hi all,

A friend of mine who is diabetic (medicine controlled) is changing jobs. There will be a gap of a couple of months between the previous insurance ending and the new kicking in. Do you have any suggestions about what to do in those in between months?

There is the option of not taking any insurance for that limited time and buying pills and testing supplies on her own. Her diabetes is well controlled and there are no additional complications that need medical support.

But I think there is a risk in doing so. What if something like an emergency accident or anything like that happens in between? that would cost a lot.

Any suggestions to handle this situation? Are there any short term insurance options that do not cost too much?

4 replies

kdroberts 2011-03-21 15:14:35 -0500 Report

As long as the employer has more than 20 employees they should be eligible for COBRA and they should take it. Without insurance for more than 64 days then diabetes will be classed as a pre-existing condition and almost certain any claim relating to it will not be covered for 12 months. COBRA will give them continuous, creditable coverage. An individual plan usually won't count as creditable coverage. By law they have to be notified within 14 days of leaving but keep in mind that the price will be between 100% and 102% of the actual insurance premium. If their employer picks up a lot of the cost then the price might be a lot, but it is worth it not to loose creditable coverage.

Dev 2011-03-21 15:38:54 -0500 Report

Thanks kd. Just so that I can make sure I understand it clearly - Once the first coverage expires, she has to apply for COBRA and pay for it so as to not break the continous coverage.

Does it matter that she will be joining a group insurance? It is a state university she will be joining. I had this assumption that if you are part of a group insurance the issue of pre-existing condition does not exist.

kdroberts 2011-03-21 16:14:13 -0500 Report

A company can't deny you a group policy based on pre-existing conditions but they can deny coverage of those conditions for up to 12 months. The way round it is to credit days you have had insurance previously against it but it has to be continuous and not ended 64 days previous. As long as you have 12 months continuous creditable coverage, which group plans are, which more than 64 days ago you get round the pre-existing conditions completely. If you have less than 12 months or a break of more than 64 days you will have some pre-existing condition exclusion period.

COBRA is the same policy you are on, you just have to pay the full cost up to 102%. You can buy it for up to 18 after leaving a job.

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