As we march through the dog days of summer, our office has been processing a lot of Special Enrollment health insurance applications lately. Whereas anyone can apply in November through February’s Open Enrollment, Special Enrollment is limited to those with a Qualifying Event. These are things like marriage, divorce, birth, returning to the US from abroad, or losing your existing coverage, among others.
While you can certainly get coverage in these circumstances, there is still a set of rules and structure which we must follow when applying for new coverage during your Special Enrollment period. The most important of these is timing. What we have noticed lately is that clients will call the week or even the day before their qualifying event- usually the loss of their existing coverage- and want to put a new plan into place. The problem they are running into is that while yes you are allowed to enroll in a new plan when your health plan ends, your application deadlines remain the same as they are during Open Enrollment. This means that applications received before the 15th of the month get processed for an effective date of the first of the next month. Applications received after the 15th of the month get processed for an effective date of the first of the month that follows.
For example, if you submit your application on July 9th, you will be granted an effective date of August 1. If you submit your application on July 27th, you will be granted an effective date of September 1. The problem, as you can see, becomes that if your coverage expires July 31st and you want to avoid a gap in coverage, we actually need to start the process in early July in order to properly quote your family, evaluate your plan needs, pick a plan and execute an application. An absolute minimum of 16 days prior to your loss of coverage is required to avoid a gap in coverage, although the earlier we start the process, the better.
So what if this happens to you? You successfully execute on your Special Enrollment, but now you’re left without coverage for a month. While it’s not a one-size-fits-all solution, most of our clients have success with a Short Term Health Insurance Plan. These plans can bridge the gap between your expiring plan and your new coverage to ensure you aren’t left exposed to a major medical claim without any coverage.
While short term plans can save the day in a pinch, the best result for you and your family will come from completing your application at least 16 days prior to your need for the insurance to actually kick in. Need a quote? No problem, just start here.