Gap health insurance is a temporary solution during a time you would not have health insurance coverage. Gaps in coverage occur for many reasons, such as a job change, sudden unemployment, divorce, and more. When this happens you have several options to remain covered and still have access to healthcare. We’ll discuss the top 5 options below.
Mira is an alternative health coverage solution that can help you during your health insurance gap and beyond. For an average of $45 per month, you have access to a range of benefits and services including co-pays that cover your entire urgent care visit, COVID-19 testing, and same-day laboratory tests. Sign up today.
The Best Gap Health Insurance Options
According to a study conducted by Commonwealth Fund Health Insurance, one-quarter of adults aged 19 to 64 have experienced a gap in their health insurance, with the majority remaining uninsured for greater than one year.
The financial and psychological stress from uncovered health expenses can be scary, but you have several options to protect yourself from the financial stresses of being uninsured.
Through these options, you may be able to continue access to affordable healthcare.
Short-Term Health Insurance
Short-term health insurance is a type of gap insurance that can give you coverage in the case of an emergency. These plans can be canceled at any time and are generally used for either gap needs or by those without many doctor needs. These plans help to bridge the gap between coverage periods for many Americans.
Pros: Most plans last up to three years and are relatively cheap, but coverage is limited.
Cons: You may have to pay high out-of-pocket costs for visits outside of the 10 essential health benefits using short-term health insurance. Additionally, many states do not allow for short-term health insurance plans, while others cap their use at three to six months.
Catastrophic Health Insurance
Catastrophic health plans are more long-term insurance aimed to just protect you from an emergency or serious accident. Catastrophic health insurance has low monthly premiums and high deductibles. They are typically used for “worse case scenario” situations.
Pros: Catastrophic plans cover essential health benefits as well as preventive services at no cost. They also cover at least 3 primary care visits per year before you’ve met your deductible.
Cons: Not everyone is eligible for catastrophic coverage. Only people under 30
or people of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance being unaffordable), are eligible. They can also be costly.
Supplemental Health Insurance
Supplemental health insurance can help to cover the medical expenses for services that are not usually covered through traditional health insurance. Some examples include dental insurance, critical illness insurance, and vision insurance plans.
Not all supplemental health care plans pay for the same expenses. For example, some supplemental insurance plans will pay for deductibles, coinsurance, and out-of-pocket health care costs directly.
Pros: Supplemental insurance can make a big difference financially when it comes to medical care- it could mean saving a lot of money when incidents occur. Many plans are inexpensive.
Cons: It adds additional expenses to your healthcare budget. It also does not cover all expenses when it comes to your healthcare needs.
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Get doctor visits, lab tests, prescription, and more. Affordable copays. Available in 45+ states. Only $45/month on average.
How Mira is Different
Foran average of $45 per month or $300 annually, you become a Mira member. A Mira membership includes access to affordable all-inclusive urgent care visits, same-day lab tests, COVID-19 testing, discounted prescriptions, and more.
Pros: 400+ affiliated walk-in clinics, 1600 laboratories, and 60,000 pharmacies. Virtual care appointments with a $25 co-pay. Mira will keep you covered for your primary care and urgent care needs until you are able to obtain long-term insurance. Mira also covers virtual mental health visits.
Cons: Mira does not offer coverage for hospital visits, or vision and dental services.
When to Consider Medical Gap Insurance
Gap health insurance is especially helpful for those who are in a temporary position of not having health insurance. Some situations in which this would be applicable include:
- Transitioning to another job
- Loss of employer-sponsored insurance
- Attending an out-of-state college or university
- If you are waiting for the annual Open-Enrollment period
Gap Health Insurance Frequently Asked Questions (FAQs)
Gap health insurance, or medical gap coverage, is straightforward but it could happen when you least expect it. Make sure you understand how it could impact you before it happens so that you always have the coverage you need. Below we look at some of the most common questions surrounding gaps in coverage.
What should I do if I’m in a health insurance gap?
If you’re in a health insurance gap then you should follow these 4 steps:
- Identify the exact date you will lose coverage.
- Try your best to determine when you will regain long-term health insurance coverage. There are different options to bridge your coverage gap, and understanding how long you will be without a long-term coverage plan may help you decide which option suits your needs the best.
- Research all your options and consider the pros and cons of each. In this article, we have highlighted several of your options, but you should still consider more extensive research to identify the best approach that suits your needs.
- Having no health insurance can be dangerous for your financial, psychological, and medical well-being. Once you have determined which option is best for your needs, you should sign up and get covered as soon as you can.
Virtual care for only $25 per visit
Virtual primary care, urgent care, and behavioral health visits are only $25 with a Mira membership.
Can I use my spouse or partner’s health insurance?
Yes, typically you can have your spouse or partner add you to their insurance plan. Under normal circumstances, you cannot change your insurance unless it’s during the open enrollment period. However, when you lose your job or are undergoing a special transitional period in your life (e.g. getting married or having a child), you have the option of a special enrollment period in which your spouse can add you to their insurance plan.
Am I qualified to use Medicaid as an insurance option?
Medicaid qualification will depend on which state you live in and your annual income, but Medicaid is a low-cost option with consumer protections (including pre-existing conditions) that can help you stay protected from the financial burdens of paying for healthcare out-of-pocket.
How does COBRA work?
The Consolidated Omnibus Budget Reconciliation Act (COBRA) is another option for people to buy health coverage under their employer-based health plan.
Employers with at least 20 employees are lawfully required to provide this option to members of the company that lose their job.
Under this option, you will be able to keep your same plan for 18 months; however, you should note that this option is quite expensive. Being that your former employer no longer has to cover anything, you can expect to pay high premiums.
The Bottom Line
While in a health insurance gap there are many options to consider, including short-term health insurance, catastrophic insurance, and other alternative options. Each option has pros and cons, so you should do research to decide which one best suits you and your healthcare needs. Just make sure you find the one that gives you the right coverage at the right price.
Spencer is a Public Health & Biology undergraduate student at New York University.