As you review the options, you’ll want to keep a couple of things in mind.
- While you want to make an informed decision, you don’t want to procrastinate. Almost every program has a time limit within which you need to act.
- Do all you can to avoid a lapse in coverage, even for just a few months. Going without, even for a brief period, may mean you’re not covered when a serious accident or illness hits.
Moreover, another federal law—HIPAA, for the Health Insurance Portability and Accountability Act—comes into play. HIPAA requires insurers to cover even preexisting conditions like diabetes as long as you’ve maintained health insurance, generally for at least 18 months and without a gap in coverage of more than 63 days. The insurance can be through an employer, the government, COBRA or an individual policy, says the Georgetown Health Policy Institute’s Lucia.
If you’ve let your coverage lapse too long and you later apply for insurance, the insurer may accept you but exclude any conditions you had at the time of your application—and continue to exclude them from coverage for a year.
Where to get help
The Center for Patient Partnerships at the University of Wisconsin-Madison offers patient advocacy services.
The Foundation for Health Coverage Education offers information on affordability and eligibility for plans across the country.
Health Plan One, a Web-based health insurance brokerage, offers plans from 100 companies.
You can find information on COBRA and other regulations online through the U.S. Department of Labor, or you can reach call the department’s benefits specialists at 1-866-444-3272 toll-free.
Karen Kroll is a financial writer based in Minneapolis.