How long can you be without insurance before it's considered a lapse in coverage?

Question

I carry insurance now, which will end at the end of April. My husband's insurance will pick up on June 1. Is this too long of a lapse in coverage? And will the new insurance cover 'preexistings'?

Answer 1

The new coverage will probably not pay anything toward expenses incurred during the entire month of May. Whether it covers pre-existing conditions depends on the policy.

Personally, I wouldn't risk a month without insurance. That's the month you'll be in a car accident or need emergency surgery. (The gods laugh themselves silly at our folly.)

See if the policy you carry now will let you extend by one month for a fee. Pay it and be very grateful if you never need to use it.

Answer 2

63 days. usually

Answer 3

Per HIPAA, it is 63 days.  Depending on the laws in your state, and the type of plan you are going into, HIPAA entitles you to receive credit for prior health coverage as long as the time in between the two policies is not more than 63 days.  

Ask for a HIPAA Certificate from your current insurer or employer, as you may need to provide it to your new plan administrator or insurer.  

Also check with your husband's insurer to see what their policy on pre-existing conditions is.  It may not even be an issue, as it isn't in New York State with an HMO.

Answer 4

Technically, one DAY without insurance is considered a lapse in coverage. If you're both generally healthy, a month without insurance is not a tragedy, but it's not highly recommended.

As far as if the new insurance covers "pre-existing" - that depends on the plan. Some have what they call "waiting periods" - during which, if you seek care for what they determine to be a pre-existing condition (and it can be ANYTHING they want - I've gotten pre-existing questionnaires for a simple generic cold.) they can refuse to pay, and you have to pay - and it's legal. That can be anywhere from 30 days to a year. BUT, that can sometimes be waived, if you prove you had coverage right before you started with this plan. Insurance companies send you a letter of termination when you end your time with them. Let's say you keep this coverage until May 31st, then your new insurance should waive any pre-existing right away, as long as you provide them a copy of the letter. If you go the 31 days without insurance, they don't have to honor that. So, my advice would be -first I would call the new insurance company and ask them if there is a waiting period, and how long it would be, but if you have ANY kind of chronic condition (even allergies!), I'd shell out for the COBRA just to avoid the waiting period.

Answer 5

With the new insurance..you have to read the policy to see if pre existings are covered.  Make sure you find out. That is very frustrating to find out.  Especially if you have previous issues that you have to be maintained.  Lapse of coverage is any time period where the insurance is not being paid.  Depends on if you are anticipating anything happening in that one month that you won't have coverage.  You are talking about health insurance right?

Answer 6

As with all things Health Insurance, there are different practices in different states.

If it is group coverage through an employer, you should be fine.  Employer Group Coverage typically needs a 60 day lapse in coverage (or more) to add pre-existined condition exclusions.  In California, even that is only temporary on a group plan, and after 6 months of being insured, your pre-ex will be covered again.