Loss of health insurance coverage for people
with diabetes can be serious because of the need for medications,
insulin, supplies and doctor visits. A gap in coverage also leads
to future problems in obtaining coverage because of exclusions or
waiting periods due to pre-existing diabetes. To avoid loss of coverage,
consider the tips and facts below:
- COBRA is a federal requirement for all insurance plans to provide
continued coverage after termination of benefits. COBRA coverage
must be applied for within 60 days.
- Termination or change of employment - Coverage can be continued
for 18 months, beneficiary pays the full premium, must be applied
for within 60 days of termination of coverage. Arrange continued
benefits either through the employer or through the insurance
plan customer service.
- Termination of coverage due to age - A child who becomes ineligible
for coverage on a parent's policy due to age or marriage, is still
eligible for continued benefits through a COBRA plan for another
3 years. Arrange continued benefits either through your employer
or through the parent's insurance plan customer service.
- Termination of coverage due to divorce - An individual who previously
had coverage as a dependant through a divorced spouse is also
eligible for COBRA. Children can also be included.
Avoid pre-existing condition waiting periods due to loss of
Don't let a temporary gap in your coverage
make you uninsurable.
- A change in employment can cause you to lose insurance coverage
or have a 6-12 month waiting period for a pre-existing condition.
- If the time you have no insurance is less than 63 days, the
new plan is required by federal law to provide insurance without
a pre-existing condition waiting period and you cannot be declared
ineligible (you must obtain a certificate of coverage from the previous plan).
- Some employers require a 30 to 180 day employment probation
before you become eligible for the new company's health
plan. If insurance is applied for at the earliest possible eligibility
date, this probationary period cannot to be counted against the
allowable 62 day gap in service.
- Affected individuals should verify their eligibility with human
resources at the new employment. When in doubt, consider the benefits
of COBRA coverage to bridge the gap for those in the family with
chronic health conditions.
Utah regulated insurance plans
- Commercial Utah based insurance plans provide coverage for unmarried
children until age 26. It may not be required that students or
divorced children live with the parent.
- You may have a national plan, or an employer funded or union plan with
a lower termination age.
- When changing employers, divorcing, marrying, giving birth,
adopting, accepting a foster child, or reaching the age when your
insurance coverage ends, always check your coverage options with
your health plan customer service department.
- You may contact a health insurance analyst in the Insurance
Commissioner's Office at
(801) 538-3874 or 3873.