GeoffM

My wife is switching jobs at the end of this month and her new coverage with Blue Shield doesn't take effect until June 1st. Her current employer has said her Kaiser Permanente coverage will end the day after she terminates her employment. They said we can continue with KP but will pay full rates.

Since the new healthcare laws came into place, is this correct information? Most of the stuff I've found predates the new laws (whether it makes any difference, I don't know).

On an unrelated note, last September we took our nanny (uninsured) to urgent care. We paid her bills at the time as DD caused the problem. Suddenly this week we get a demand from a collections agency for an unpaid bill. No other communication was received from the clinic in that time. We've written to the collections agency asking them to put a hold on it while we investigate but is there anything else we can do? We suspect it's a doctor's bill, separate from the bills paid at the time, but as we didn't get such a bill, we haven't had an opportunity to negotiate with the clinic - not to mention paying a collections agency as well.

Leslie

What they are telling you is correct.

This may be helpful:

https://www.healthcare.gov/what-if-i...sed-insurance/

https://www.healthcare.gov/what-if-i...obra-coverage/

I think you will probably be better off dropping the COBRA coverage and buying a short term plan through the marketplace.

Giantaxe

Or simply doing nothing and applying retroactively for COBRA coverage in the event that you need non-trivial healthcare during that gap. You have 60 days to sign up for COBRA which more than covers the period the OP mentions. Of course that leaves you with the risk that you'll retroactively have to pay $$ for two months of COBRA coverage versus the knowledge of whatever premiums you'd be charged when purchasing a policy from an ACA exchange.

Leslie

Yeah, I think it would probably depend on how cheap of a plan they could get though the exchange. If it's just as expensive through the exchange then your suggestion is the obvious way to go.

jibsymalone

This was one concern I had, and another reason I HATE the US healthcare system. My new coverage will not start until after a 90 day period, but I still have the pleasure of paying for it! Luckily I have enough bank hours on my previous plan to cover me for 6 months after I terminate. What would someone who's insurance, like the OP, expired on your last day with the company do? Oh yeah, PAY MORE MONEY!! If they make you wait a period of time before you can claim then they should add this time on to the end of your policy when you cease to continue paying

malch

COBRA rates are usually pretty high. However, it seems the gentlemen only needs coverage for the one month of May.

In that case, and given that it's Kaiser, I would just go COBRA and eat that cost versus shopping around for one month of coverage. It will be a whole lot simpler.

And, as a Kaiser member you can probably get a discount on some petroleum jelly to ease the pain :-)

Leslie

I don't disagree that it would be easier that way but the OP needs to compare costs and decide for himself. If the cost of Cobra is $700 and she can get a marketplace plan for $200 ... it's something that should be considered anyway.

GeoffM

Before she started the job we were paying $1500 per month for two adults and two kids. Currently she pays about $400 from her paycheck. HR told her that she'd pay $1200 privately though I'm not sure if that was a guess or what. [Edit] coveredca.com quotes $1149 for KP Platinum coverage so maybe that's where the figure came from.

So are you saying we could not pay for healthcare and if an emergency happened we could backdate the premiums and still be covered? Seems too good to be true!

The gap in coverage would be about 35 days.

GeoffM

Oh, years ago I looked at using my company-of-one to enroll in healthcare as a business but in CA the company had to be two or more. Looking on coveredca.com it says one: has that changed then? That might be another option if so. After all KP keep sending me mailings to join them, which I summarily discard every couple of weeks!

Giantaxe

That's correct for COBRA coverage but not for a policy you would buy from an ACA exchange. This is what I've done several times when I've had gaps between jobs. I always made sure I got prescriptions etc prior to my employment ending and I never did end up having to sign up for COBRA. When your spouse gets the COBRA papers from her employer, they are required by law to explain this to you. And of course, there's also plenty of material online about the ins and outs of COBRA coverage. Just make sure that if you do need coverage, you get payment to whoever requires it before the deadline. Otherwise, you're out of luck. What I did was write a check and envelope at the beginning of the COBRA period and let a friend know where it was just in case we were all involved in an accident etc.

Edit: I think there might also be a grace period on an ACA policy before payment must be made but I'm not sure of the details.

Edit2: COBRA also has the advantage that you can't be subject to a new set of yearly deductibles etc.

Leslie

And if you need to get treatment in the interim you will basically present as uninsured and will probably be expected to pay out of pocket.

Giantaxe

Absent an emergency (which they can't legally deny you treatment for if you refuse to pay out of pocket) how much (reimbursable) cost could one plausibly incur for non-emergency treatment before you got your COBRA payment in?

Leslie

I don't disagree. For a healthy family for just one month it should be fine but I think he should know that he'll present as uninsured.

I don't know the OPs situation. I am aware of nightmare scenarios for people whose COBRA wasn't showing up as active and they needed treatment.

Giantaxe

Yes, I agree that's a risk, but it's a risk that it shares with all new insurance, including an ACA policy.

And if I had a family member that I knew would likely need non-trivial treatment during the window I certainly wouldn't go the "retroactive COBRA" route.

Leslie

These weren't even people doing the "retroactive" route ... just victims of slow HR and insurance bureaucracies.

But, yes, unless any of them have serious chronic health conditions, the odds are with them.