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How to Take Care Of A Gap In Medical Insurance Coverage

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gap in medical insuranceThe purpose of health insurance is to make sure that you are covered in case of an emergency, if your health suddenly worsens or if you need to deal with a chronic condition that you would otherwise never be able to afford to treat. However, no matter how diligently we plan out our insurance coverage and work to make sure that we have everything we need, every so often we might experience gaps in our coverage — and if this happens, it can be worrying (not to mention costly) to go without insurance for a while.

However, if you experience a gap in your medical insurance coverage, you have options — besides paying the monetary fine exacted for not having health coverage, which is required under the Affordable Care Act. You might be facing a gap if you suddenly lose your job and no longer have access to your workplace insurance, or if you will be enrolling in a group plan but your coverage doesn’t start for another few months. In any case, you can take steps to make sure that you are insured at all times.

Open Enrollment

To start, if you leave your job and will no longer have access to job-based insurance, you can buy a plan on the federal insurance marketplace. Each year, the Marketplace has an Open Enrollment period (From October to December) during which time people can enroll in health care plans for the upcoming year; however, losing your job-based coverage (whether it’s because your quit or were fired) entitles you to a Special Enrollment Period during which time you can buy insurance. Your new policy can begin on the first day of the month after you initially lost your insurance.


Then, there’s COBRA continuation coverage, which allows you to keep your employer-based health plan for a period of time (usually 18 months) after you leave your job. COBRA is a federal law that is meant to cover the gap for people who lose their insurance suddenly, while they look for alternate forms of insurance that can start officially within the next year. With the COBRA plan, you pay the insurance premium and an administrative fee, but don’t have to deal with the nitty-gritty of getting an entirely new policy (For at least a while).

Private Insurance

On the private insurance market, you can find policies that cover gaps ranging from one month to one year. These policies will incorporate different benefits, so that you can choose the one that works best for you and is in the price range that you are willing to pay. Features can include office co-pays, prescription drug coverage and low deductibles, for example, and you can decide whether you want (and are willing to pay for) a plan that includes these things or not.

Consider Your Health

Furthermore, the state of your health can also affect the short-term insurance plan that you choose to purchase. For example, people who are medically underwritten to receive short-term insurance sign an agreement stating that they don’t have any medical conditions that would prevent them from qualifying. Under the Obamacare law, the provision banning discrimination on the basis of pre-existing conditions does not apply to short-term insurance policies.

Guaranteed Issue

A guaranteed issue plan, meanwhile, can be beneficial for those who have ongoing health concerns and just need to bridge a gap between their current health coverage and a group plan or Medicare policy that they will soon have. Typically, these plans will not cover preexisting conditions, but will keep you insured against unforeseen circumstances while you wait for your full coverage to kick in.

Location and Restrictions

Unfortunately, due to the location in which you live, the duration of your short-term health insurance plan may be restricted; For example, some states only allow short-term insurance plans that last a maximum of six months; this means that you will soon have to purchase and qualify for a full health insurance plan. Obamacare policies shorten the time line with three months on a short-term plan in order for you to avoid paying the penalty.

Under the current rules, short-term policies do not meet the standard of Minimum Essential Coverage. So it’s important to figure out what the rules are where you live, and to pick out your short-term insurance based on that. Ultimately, you can fill the gap in your medical insurance coverage with short-term insurance policies, as well as the public options listed above that form a more long-term solution.

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Category: Health Insurance

Last updated on December 3rd, 2017