How do I switch health insurance companies without a gap in coverage? Author:    Posted under: Health InsuranceHealth Insurance questions answered


It’s bound to happen, one way or another. Graduating from school, losing dependent status or changing jobs – even a divorce could force you to switch health insurance providers. You want to make sure that you’ll still be getting the best coverage under a new insurance company. Additionally, it won’t be to your favor to allow a lapse in your coverage given how health insurance treats gaps in coverage.

Determine legalities. Read and understand your policy carefully. If something is unclear to you, call the customer service department of your insurance company to clarify these details. Federal laws that address the portability of health insurance exist, such as the 1986 COBRA bill and the 1996 HIPAA Act. If you are considered a qualifying beneficiary, these will give you the benefit of continuing coverage.

Exclusions, scope of coverage and limitations. Ascertain whether your new plan will be able to meet all your health needs. There are insurance companies that do not provide coverage for pre-existing conditions (such as diabetes, heart disease and even pregnancy). Other times they will, but waiting periods have to be satisfied before the policy can be enforced. If this is the case, you may need to find an alternative solution to avoid a lapse.

Alert the appropriate authorities to take advantage of COBRA. If you are a qualifying beneficiary, write a letter to the human resources personnel from your former job that’s in charge of alerting the group plan administrator to notify them of your intent to continue coverage under COBRA. Generally, they need to be alerted of your intent within 30 days of the occurrence of a qualifying event. You will need to shoulder the full amount of the coverage (and an administrative fee) yourself, but you will at least have extended coverage for a limited amount of time, usually lasting 18 months.

Remain covered under another’s coverage. If you’re married, you can remain covered by your spouse’s health plan until your own policy can be enforced.

Your primary care physician and medical records. Be mindful that your new plan may not have the same network as your current one. Find out beforehand if you will still be able to see your primary care physician and other routine medical professionals. If not, explore another policy that might allow you to continue seeing them under your new coverage. If, however, this is impossible, then you will need to take note of certain information so that your medical records will be able to follow you without great difficulty. These are:

  • Your provider’s business name
  • Provider’s full name
  • Provider’s complete address
  • Providers contact details such as telephone and fax numbers
  • Your date of last visit
  • Most recent prescribed medications and courses of treatment

Consider short-term health insurance from a private health insurance provider. Also known as temporary health insurance, this type of plan is designed to provide individuals with an alternative medical coverage whenever there is a gap in your normal health care coverage. If you are in between jobs, have lost your group health insurance coverage and are not eligible for COBRA, then short-term health insurance just might be what you need. This might not be the cheapest option but you will be covered during the time that you would otherwise have none.

Keep your records from the previous health insurance provider. Since bills can take quite a bit of time to move through the system, it will prove to be most beneficial if you keep your old records in case a dispute comes up.

Finally, wait until you are covered before cancelling your previous health insurance coverage. Your medical needs and consequently, the bills that need to be paid, will not wait. Any lapse in your coverage might be more costly than you can manage to take on financially.

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