The consequences of putting off until tomorrow what should be done today can be quite serious when it comes to your health insurance. It doesn’t matter if you are changing jobs, changing insurance plans, becoming eligible for Medicare, submitting claims or just paying the premiums – time is of the essence and you may jeopardize your ability to get good health insurance if you do not make decisions in a timely fashion.
When you change jobs, if you work for a company with 20 or more employees, your employer will give you the opportunity to continue your health insurance benefits for a limited period of time. Usually, people will continue their COBRA benefits until they become eligible for benefits under another group plan. When your employer sends you a letter informing you that you have the right to continue your benefits under the COBRA law or under the New Jersey Continuation of Benefits law, there is a time limit in which you must respond. The sooner you make the decision and return the letter, the better. If you are eligible for COBRA benefits, you must notify the employer in writing that you wish to continue your benefits and this must be done within sixty days of the date you receive notice from your employer that you are eligible to continue your benefits. If you work for a company with fewer than 20 employees you can continue your benefits for 12 months but you must notify your employer in writing within 30 days of the date of your termination. This also applies if your work hours have been reduced to the point that you would no longer be eligible for health insurance benefits.
When you become eligible for Medicare, if you have been receiving Social Security retirement income, you will receive your Medicare card about three months prior to it becoming effective (the first day of your birthday month). Do not wait until your 65th birthday to decide that you want to purchase a Medicare supplement or that you wish to choose an HMO in lieu of Medicare, or that you wish to continue on your former employer’s health insurance benefits as secondary to Medicare. You create stress in your life by waiting to the very last minute. If you are applying for a Medigap plan, you will make life easier for yourself if you submit the application about a month prior to the effective date. So, if you are turning 65 in January, and your Medicare benefits start on January 1, 2003 you should submit an application during the first week of December.
Paying your premium in a timely fashion is also very important. You should mark your calendar so that you know when your various insurance policies fall due. Most companies do offer a 30-day grace period if you are late with the premium. However, I do not recommend getting in the habit of paying the premium during the grace period. Pay it on time. I cannot stress enough how important this is. If you go to Macy’s and select a number of items for purchase, they will not let you out of the store unless you pay for them. Think of that analogy when it comes to your insurance: If you do not pay the premium they will terminate your coverage! Insurance is like any other item or service you purchase, you must pay for it or you do not get it.
Insurance carriers really do not care if you were away on vacation and forgot to pay it, or were ill, or the mailman dropped it in the bushes. If you do not receive the bill, it is YOUR responsibility to contact the company and seek guidance on getting the premium in on time. If you have an agent, call that person. If not, call the company directly.
When you have a baby, the claims will be covered for the first 30 days of life under the mother’s policy but it is still necessary for you to complete an application for the baby and submit it to the insurance company within 30 days of birth. If you do it after the 30-day period, the baby may be subjected to waiting periods for preexisting conditions or have other penalties attached.
There is also a time limit for submitting claims to your insurance company. The standard time allowed to submit claims varies from one insurer to the next. Many companies will allow you submit up to one year from the date of service and yet others will allow you to submit the entire preceding calendar year plus the current calendar year. You should check your policy (there is usually a section toward the back of the booklet that will tell you about the procedure for submitting claims). If you cannot find anything in writing about the time period for submitting claims, be sure to call your insurance company.
Irene Card & Betsy Chandler share the responsibilities of running Medical Insurance
Claims, Inc. a health insurance services company. If you have questions relative to this
column or other related topics, we invite you to call (973) 492-2828, browse our
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