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health insurance gap

Summer has finally arrived and with it a new wave of graduates ready for the workforce. This is an exciting time for any new graduate. However, some of you may have some concerns about how to go about handling certain parts of adulthood on your own for the first time— like insurance. Health insurance is a necessity for adults, so understanding how it works is incredibly important. This includes understanding and preparing for an impending health insurance gap by asking the right questions.

What is a health insurance gap?

A health insurance gap is simply a period of transition between insurance plans. It usually happens when you are no longer eligible for the health insurance plan you had but are also not immediately covered by a different plan. Health insurance gaps can happen for a lot of reasons. When people quit their jobs or get fired, they lose any employer-provided coverage they might have had. When someone gets divorced, he or she loses the insurance coverage under their ex-spouse’s plan. Graduation from a college or university, however, is a situation that almost always triggers a health insurance gap. If you were covered by a student health plan that no longer applies since you are no longer a student, you have entered a health insurance gap.

What if I just graduated and I don’t have health insurance anymore?

Many recent graduates are faced with this situation. Thankfully, for most graduates, parents can assist with the health insurance gap when their student plans run out. The Affordable Care Act allows for anyone to be covered by their parents’ health insurance plan. This form of coverage lasts until you turn 26. So, your parents can just add you back onto their work-based health insurance policy once you graduate.

Will I be covered by my employer when I get a new job?

You will most likely be covered by health insurance provided by your employer. However, there are a couple of factors to consider before settling for a company health insurance plan. The first is that you would probably still be faced with a health insurance gap for a while. Most businesses don’t cover your health insurance until after the first 90 days of your employment, and if you are over 26 years old, you can’t be covered under your parents’ plan. The second is that most businesses provide group health insurance. This means that the insurance is based on the average cost for all employees, not just you. So, you would be contributing to the coverage for others who may have much higher healthcare costs than you. If you are young and healthy, you may be better off finding a health insurance plan outside of your company’s coverage. It would be less expensive and more convenient than a group policy.

Will getting a short-term plan help fill a health insurance gap?

Short-term policies can offer some protection in the event of an unforeseen medical emergency, but for the most part, their coverages are extremely limited. Most short-term polices last between one to twelve months, and unlike most health plans, applicants might be rejected if they have pre-existing medical conditions.

If I have a pre-existing condition, how can I afford my medication during a health insurance gap?

If you regularly take medication and find yourself in the middle of a health insurance gap, it’s very important to continue taking the medications you need. Letting the doses run out without refilling them could have negative effects on your health. This is why patient assistance programs exist. Patient assistance programs ensure that anyone who does not have insurance and cannot afford their prescribed medications can still have access to them. This is a resource that is especially helpful for graduates going through a health insurance gap.

How do I know if I’m eligible for a patient assistance program?

Every program is different, but some of the qualifications remain the same no matter what. Usually, you are eligible for patient assistance programs if:

  1. you are a United States citizen and/or have legal residency
  2. you have little or no prescription insurance coverage, like during a health insurance gap
  3. your income exceeds that which is defined in the Federal Poverty Guidelines

If you meet these and any other specified qualifications, then you are eligible for patient assistance.

Where can I sign up for patient assistance?

At Rx Helper, we can help you through your health insurance gap. Our enrollment process is simple and we offer a range of both generic and brand name medications for whatever conditions you may have to treat. If you have recently lost your student insurance coverage, Rx Helper can help bridge the gap as you transition to another health insurance plan. If you have any questions or would like to find out more about our patient assistance programs, please give us a call at (877) 767-3297. And congratulations, grads!

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