Temp HI for my son

[LRDave]

DS#2 started his first salaried job that includes health insurance benefits on July 8th. (yay!) He is not eligible for coverage for one month - August 8th.

My company paid COBRA coverage (that includes him) expires July 31st.

Would some reputable short-term HI be the best option? I am moving the DW's retiree health insurance plan. Adding him for one month to that plan will cost $600. Plus it is a real hassle making changes to DW's SHBP.

Anyone have a similar super-short insurance gap experience ? TIA.

 

[joeea]

DS#2 started his first salaried job that includes health insurance benefits on July 8th. (yay!) He is not eligible for coverage for one month - August 8th.

My company paid COBRA coverage (that includes him) expires July 31st.

Would some reputable short-term HI be the best option? I am moving the DW's retiree health insurance plan. Adding him for one month to that plan will cost $600. Plus it is a real hassle making changes to DW's SHBP.

Anyone have a similar super-short insurance gap experience ? TIA.

Add him. Have him pay the $600. You absorb the hassle. Everyone is protected.

 

[The Cosmic Avenger]

The first thing I would suggest would be to call your current insurer on Monday and ask 1) if you can pay them out of pocket to convert your COBRA plan to private pay, and if so, 2) what it would cost for one month or if they can do 7 days (Aug. 1-7). If it is $600 or less, it would still save you the hassle of paperwork if you're extending existing coverage. And even if it's basically a new plan, they might be able to do it with a lot less paperwork than signing up for a totally new plan.

 

[njhowie]

Go without for the 3 weeks. Sure, there is a very small risk. However, since his days are primarily going to be at work, he won't be out and about doing anything that will increase risk of having an accident. If he gets injured in the office, employer's insurance will cover it. So, technically, as far as activities where he may injure himself, it's really a few weekends. Also, the chance of him coming down with and being diagnosed with some disease in the next 3 weeks is likewise extremely slim.

For anything else which may come up, just pay out of pocket - go to CVS Minute Clinic, Urgent Care, use GoodRx/WellRx.

For the past 5 years we've rolled daughter from one temp plan to another while she lived in states which offered it and plans offered at the university where she took classes in the summers. There's routinely been lapses of several weeks where she went without.

If I'm reading your post correctly, it's actually only 1 week lapse as he is covered on your Cobra until July 31 - so the gap is just the first 7 days of August. If you do get him covered on another insurance plan today, while still covered by your Cobra and he does utilize it, it may actually complicate things as he will be covered by more than one plan and require coordination of benefits.

It's likely not going to be worth your efforts.

 

[MichaelB]

DS#2 started his first salaried job that includes health insurance benefits on July 8th. (yay!) He is not eligible for coverage for one month - August 8th.

My company paid COBRA coverage (that includes him) expires July 31st.

Would some reputable short-term HI be the best option? I am moving the DW's retiree health insurance plan. Adding him for one month to that plan will cost $600. Plus it is a real hassle making changes to DW's SHBP.

Anyone have a similar super-short insurance gap experience ? TIA.

The first thing to do is have your DS check with HR to see the actual start date of the new insurance policy. Many policies automatically date to the 1st of the month, which in this case could be Sept 1 or even Aug 1.

If he still needs coverage, I would look for a short term policy that primarily covers emergencies. For such a short time he really doesn’t need anything else. Some of the large insurers such as UHC sell it and for this purpose it is a reasonable and cost effective alternative.

 

[Jerry1]

I would not go without coverage. I don’t know all the rules, but I seem to recall a lapse in coverage being something that can prevent you from getting coverage in the future. Sure, in three weeks there will be coverage, but who knows, he could get fired. If you go without coverage, all I’m saying is know the risks.

 

[njhowie]

I would not go without coverage. I don’t know all the rules, but I seem to recall a lapse in coverage being something that can prevent you from getting coverage in the future. Sure, in three weeks there will be coverage, but who knows, he could get fired. If you go without coverage, all I’m saying is know the risks.

Not true for the most part.

If you are attempting to get an ACA insurance plan mid-year outside the re-enrollment period due to a qualifying life event, the insurance company will ask for proof of insurance up until that point. We just did this as daughter moved home from her last residence where she had the temp plan. That temp plan ended early May. We started her new ACA (non-temp) plan June 1 providing the proof of the prior insurance ending a few weeks prior with no hassle. With the temp plans, they do not ask for proof of prior insurance and you can sign up at any time without any requirements.

As far as getting ACA insurance during the annual re-enrollment period, there are no requirements for having prior insurance. Last year, due to a billing screw up with my insurer, I was canceled in February. When I attempted to get it resolved I was SOL and went without coverage the remainder of the year. During the re-enrollment period at the end of the year, I re-enrolled with no questions asked. Of course, when tax time came I had to pay a decent size penalty for going without for most of the year.

 

[ziggy29]

The concept of maintaining coverage to guarantee insurability was a part of the HIPAA law passed in 1996 (aka Kennedy-Kassebaum). But since the ACA now prohibits medical underwriting or pre-existing condition exclusions for qualified plans, it has been superseded by provisions in the ACA.

It is worth remembering, though, just in case these aspects of the ACA are repealed -- since Kennedy-Kassebaum was never repealed itself, presumably its provisions would take hold again if that happened.

For someone young and healthy, it would not be a big deal to get temporary insurance until employer insurance or the next ACA open enrollment came.

 

[Bamaman]

Let him go 1 week without insurance. Just don't let him do anything risky during that week--keep a low profile. $600 for one week's coverage is just excessive.

 

[ziggy29]

Let him go 1 week without insurance. Just don't let him do anything risky during that week--keep a low profile. $600 for one week's coverage is just excessive.

One month of catastrophic temporary coverage can be had for under $100 for an individual. And while it's sort of "junk insurance" in most ways, I think this is the exact kind of situation for which it is an appropriate product -- just something that covers against a catastrophic event for a short period of time. In this case, that $100ish premium would provide catastrophic coverage through the month of August until the employer coverage kicks in.

Also agreed with the above that these employer group plans often only become effective on the 1st of a month or on the first day of a new pay period, so becoming eligible on August 8 might mean it's effective on the first day after 8/8 when new insured can come aboard -- as mentioned, it could be as late as September 1. Check with the HR benefits team.

 

[pb4uski]

Have you checked out getting a catastrophic policy through your state exchange? Here, a catastrophic policy is $250/month.

 

[joeea]

Go without for the 3 weeks. Sure, there is a very small risk.

Small risk of a huge liability = big mistake trying to save a few dollars.

 

[pb4uski]

Have you checked out getting a catastrophic policy through your state exchange? Here, a catastrophic policy is $250/month.

Looks like a catastrophic policy in your area would be ~$227/month according to healthsherpa.com

 

[LRDave]

Thanks for all the feedback errbody! Looks like step 1 is to ensure DS knows EXACTLY when coverage can start (Aug.1, Aug.8 or most likely Sept. 1).

I think from there I will advise either a short-term policy (which is crappy and likely full of holes, but cheap) for 1 month or a catastrophic policy as suggested by pb4uski - again one month only.

 

[njhowie]

Thanks for all the feedback errbody! Looks like step 1 is to ensure DS knows EXACTLY when coverage can start (Aug.1, Aug.8 or most likely Sept. 1).

Absolutely.

I think from there I will advise either a short-term policy (which is crappy and likely full of holes, but cheap) for 1 month or a catastrophic policy as suggested by pb4uski - again one month only.

Be aware that whether short-term or catastrophic the full deductible and out of pocket maximum apply - even if the policy is just for one month. Meaning if you have an accident the full deductible ($7900 in the case of the catastrophic policy pb4uski suggested) applies before the insurance pays anything.

Lastly, it may be a moot point altogether as you may not be able to start a new short-term or catastrophic policy for Aug 1 if the application is submitted on/after the 15th of this month - Sept 1 may be the earliest start date. Something else to check.

 

[LRDave]

Lastly, it may be a moot point altogether as you may not be able to start a new short-term or catastrophic policy for Aug 1 if the application is submitted on/after the 15th of this month - Sept 1 may be the earliest start date. Something else to check.

Excellent point! Thanks for the heads-up!

 

[copyright1997reloaded]

Having had a child who required three emergency "out of the blue" surgeries in a span of three weeks, I would never willingly have my child go uninsured.

Total cost was over $100K (brought down to about $65K in terms of what the insurance company paid), and could have been far far worse. I paid a total of about $250 out of pocket.

 

[pb4uski]

One thing to keep in mind, if his employer plan is more expensive than a catastrophic plan, he can chose the catastrophic plan if he wishes to... keeping in mind that the deductibles of a cat plan are probably a lot higher than the employer plan.

 

[njhowie]

One thing to keep in mind, if his employer plan is more expensive than a catastrophic plan, he can chose the catastrophic plan if he wishes to... keeping in mind that the deductibles of a cat plan are probably a lot higher than the employer plan.

For a 20-something year old, a full ACA plan should not be much more than the $227 you quoted for the catastrophic plan. We're currently paying $217 for a bronze plan for daughter. Obviously there are lots of differences between states, but $227 seems quite high for catastrophic.

 

[iloveyoga]

Times have changed. I know I went without insurance when I was that age and I know my folks had no more than a passing interest. They were happy when I got a job with "benefits" which at the time I did not really understand, but sure did not get into any of the details.

Same with my sons, I know they have had very brief periods with no insurance, but I honestly never thought that was my job to rectify. Different opinions for different times and people.

 

[pb4uski]

For a 20-something year old, a full ACA plan should not be much more than the $227 you quoted for the catastrophic plan. We're currently paying $217 for a bronze plan for daughter. Obviously there are lots of differences between states, but $227 seems quite high for catastrophic.

Typically, the difference in coverage between bronze and cat is minimal... same deductible in my state.

 

[pb4uski]

Times have changed. I know I went without insurance when I was that age and I know my folks had no more than a passing interest. They were happy when I got a job with "benefits" which at the time I did not really understand, but sure did not get into any of the details.

Same with my sons, I know they have had very brief periods with no insurance, but I honestly never thought that was my job to rectify. Different opinions for different times and people.

I'm now of the view that health insurance for my kids is wealth insurance for me.

I would never want to be put in a position where my uninsured kid needs that costs hundreds of thousands such that I need to decide whether to fund it or not.

 

[njhowie]

Typically, the difference in coverage between bronze and cat is minimal... same deductible in my state.

In my state, catastrophic for the kid is $160 with $7900 deductible and the bronze is $217 with $3000 deductible.

 

[ziggy29]

In my state, catastrophic for the kid is $160 with $7900 deductible and the bronze is $217 with $3000 deductible.

And interestingly, catastrophic coverage includes three PCP visits a year at no cost (not subject to copay or deductible), whereas the other, higher cost "metallic" coverages do not.

 

[pb4uski]

In my state, catastrophic for the kid is $160 with $7900 deductible and the bronze is $217 with $3000 deductible.

And I doubt that employer coverage for one is less than $160 per month.