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90 Day Waiting Period for Employer Health Coverage - What To Do?!

January 5, 2017

 

Disclosure: Some links to products on this website will earn an affiliate commission.

 

You’ve got a new job! Congrats! But your new employer’s health insurance doesn’t cover you until 2-3 months after your start date. You’re faced with the prospect of being uninsured for 2+ months!

 

 

What are your health insurance options?

 

First, the facts:

  • Some employers have coverage that begins on the day that you start!

  • Under the Affordable Care Act, coverage only has to be offered to full-time employees who work for employers with over 50 employees

  • The employer waiting period for health insurance is a maximum of 90 days. Some states have shorter waiting periods

  • The exact waiting period within that range is up to the discretion of the employer.

  • When you lose your employer provided coverage, that is usually considered a “qualifying life event.” As a result, you can pursue other options for coverage. But time is ticking! You usually have only 30 days to pursue new coverage

 

Here are some options you can explore within 30 days of losing your employer coverage

 

Wait! Ask your former or soon-to-be former employer.

They might let you stay on their plan through the end of the month, especially if they already took the premium out in your last paycheck.

 

Marketplace Plans

Go to healthcare.gov and explore Obamacare marketplace plans. Even though it might be out of the “open enrollment period,” you’ll get a “special enrollment period” because you quit or lost your job.

 

Can I get help paying my premium? You may qualify for a subsidy to help cover your premiums or you may have to pay the entire premium yourself.

What is a premium? A premium is the amount of money you are asked to pay each month to get insurance coverage.

What’s a subsidy? A subsidy is an amount of money that the government pays toward your premium. For example, your premium might be $800 a month. Your subsidy might be $600 and you might be asked to pay the remaining $200.

Do I get to choose a plan? Depending on where you live, you’ll probably have a variety of options including plans ranging from catastrophic coverage with high deductibles to more comprehensive coverage.

 

Insurance Companies

Explore your options directly through health insurance companies such as Oscar Health.

 

If I go directly through an insurance company, how will I get the federal subsidies and tax credits for my premium? If you qualify for Obamacare tax credits and financial assistance, the company will direct you to the government marketplace (healthcare.gov) to finish your application. And you can always just apply through the marketplace.

 

Important! If you buy directly through an insurance company, make sure the plan meets the minimum coverage requirements for Obamacare. If it doesn’t, you’re considered uninsured in the eyes of the IRS.

 

COBRA

If you are leaving a job with health insurance previously, you may qualify for COBRA.

 

What’s COBRA? COBRA is a law that lets you stay on your employer provided coverage for a limited time after leaving your job.

My GOD, why does it cost so much? It can be costly because you have to pay the whole premium yourself. When you were working at your job, your employer was probably paying a big portion of your premium – you might be shocked at how high the monthly payment is!

 

 COBRA: No Snakes Involved

 

 

Talk to your partner

If you have a partner, explore whether you can join their employer’s health plan. Losing your coverage might be a “qualifying life event” that allows you to join their plan.

 

Call your mom!

If you are under 26, explore whether you can go back onto your parents’ insurance. Losing your coverage might be a “qualifying life event” that allows you to join their plan.

 

Medicaid

Explore Medicaid, which is government health insurance provided at no or low cost to low income individuals. Each state has their own Medicaid offering. If you don’t have an income (such as in between jobs), you may qualify for Medicaid. Call your state Medicaid hotline to discuss it with a representative.

 

When I start my new job, do I lose my Medicaid coverage? Once you are accepted into Medicaid, you are covered until they ask you to reapply. Yes, that means you can sometimes keep your Medicaid coverage for weeks or months, even when you are working in your new job! Give Medicaid a call when you start your new job, tell them your income has changed, and ask them if you can stay covered and when you will need to provide updated income information.

 

Take a big risk – go bare

This is obviously risky and not recommended. If you have a medical emergency, you’ll be on the hook for the entire bill. However, if your only concern is avoiding the IRS tax penalty for being uninsured, it’s important to know that you can go uninsured for up to 2 consecutive months per year and still avoid the tax penalty for being uninsured. This is called the “short-term coverage gap exemption.” Also remember that the IRS considers you covered for any month that you had coverage, even if it was only one day of the month.

 

Sources and resources:

obamacarefacts.com

healthcare.gov

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