What Are the Waiting Periods for Private Health Insurance Plans?

Often, health insurance has an initial waiting period of 30 to 90 days, with 90 days being the limit required by the government. However, certain conditions and procedures may have waiting periods with longer time requirements before coverage takes effect. According to Section 2708 of the PHS Act, a group health plan or health insurance issuer that offers group health insurance coverage cannot impose a waiting period that exceeds 90 days. It all depends on the type of insurance you sign up for, from Affordable Care Act (ACA, also known as Obamacare) health plans to workplace coverage, as well as the time of year you take out it.

If you don't feel comfortable without insurance for a month, it's possible to get at least some insurance protection for emergencies with a short-term insurance plan. You can get insurance offered by your employer even if you apply outside of the annual open enrollment period of health insurance, since a new job is a “vital qualifying event” that allows you to buy important health insurance right away. Generally speaking, there is usually a short waiting period between when you sign up for health insurance coverage and when your plan actually begins to cover you. However, if the employer makes health insurance payments directly to the employee with the sole understanding that the employee will purchase health insurance with him, and there is no verification or control over the purchase, that amount is included in the salary for payroll tax purposes and would be subject to FICA taxes.

If you're facing a coverage gap, you can consider buying COBRA coverage from your former employer or a short-term health insurance plan from a private insurer in states where those policies are available. Section 18B of the Fair Labor Standards Act (FLSA), added by section 1512 of the Affordable Care Act, generally states that employers must notify each employee of the coverage options available in a health insurance marketplace (also known as an exchange). When it comes to private health insurance plans, it's important to understand that there are certain waiting periods that must be taken into account. The length of these waiting periods can vary depending on the type of plan and when it is taken out.

Generally speaking, most plans have an initial waiting period of 30 to 90 days, with 90 days being the maximum required by law. However, certain conditions and procedures may have longer waiting periods before coverage takes effect. It's also important to note that if you take out a plan outside of the annual open enrollment period for health insurance, you can still get coverage from your employer. This is because a new job is considered a “vital qualifying event” which allows you to buy important health insurance right away.

Additionally, if you're facing a coverage gap due to leaving your previous job or other circumstances, you can consider buying COBRA coverage from your former employer or a short-term health insurance plan from a private insurer in states where those policies are available. Finally, employers are required by law to notify each employee of their coverage options in a health insurance marketplace (also known as an exchange). This is outlined in Section 18B of the Fair Labor Standards Act (FLSA), which was added by section 1512 of the Affordable Care Act.

Tommy Gair
Tommy Gair

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