Mind the Gap and Make Sure Healthcare Coverage Continues

“Don’t Let Poor Healthcare Planning Ruin the Estate Plan” was the topic of a talk given recently by Maura Carley, Founder and President of Healthcare Navigation, LLC to the Estate Planning Council of Lower Fairfield County. Later that day, Carley led a webinar on “Healthcare in Splitsville,” organized by Un-tied, a resource group for divorcing women.

The recurring theme in both presentations was the enormous financial risk one assumes with a gap in healthcare coverage. Carley, a Darien resident, reminded listeners that most people in the U.S either have coverage through a job or as a dependent of someone with healthcare coverage. As a result, many of life’s events disrupt coverage. When possible, planning ahead is important.

Pre-existing conditions no longer apply with Affordable Care compliant plans but with all coverage there is a timeframe or window within which to act, Carley said. She warned that deadlines are absolute. Open enrollment for individual coverage began November 1st and ends on December 15th in most states for a January 1, 2019 effective date. After December 15th, until the process begins again next November 1st, if one loses what is called “minimum essential coverage” due to an event like aging off a plan, divorce, death of a spouse or COBRA ending, one has sixty days to apply for coverage outside the annual window in the individual market.

Carley warned that a transition from employer-based coverage to individual coverage can be particularly hazardous due to inexperience navigating the system and having to pay the insurer directly for coverage rather than having your contribution withheld from your paycheck. Carley advises all to pay premiums timely because insurers in the individual market can and will terminate coverage for late or insufficient payment.

Bottom line: No matter what your situation, don’t miss out on open enrollment if you are making a change in your healthcare.