When Can I Change My Health Coverage Provider?

Although the national Medicare program provides basic access to medical services to all permanent citizens, an insurance policy from a private medical coverage provider can add specialist care and advanced treatment options to the healthcare resources available to you. Private medical coverage is a valuable asset, and as a result, the medical insurance industry is highly competitive.

Providers work tirelessly to increase their number of subscribers, often offering attractive benefit packages and preferable premiums in an attempt to lure clients away from competitors. The good news for the shrewd consumer is that private medical policyholders are free to switch their coverage providers at any time. This forces insurers to deliver as much value as possible to their clients to remain competitive.

Doctor and his stethoscope
photo credit: Alex E. Proimos

The Drawbacks

However, there are some practical limitations on switching providers that should be weighed against any advantages the move may offer. By federal law, insurance providers can impose up to a two month waiting period before a new member can receive full benefits from a policy.

During this time you will have access to partial coverage, but if an emergency arises in the interim, addressing it with your pending policy can prove problematic. Your limited temporary policy may not provide nearly the level of cover you need in your situation, leaving you responsible for covering substantial expenses such as drugs, therapy costs and medical equipment out of pocket.

Doctors with patient
photo credit: Seattle Municipal Archive

Policy Upgrades

Of course, a provider can waive this two month waiting period as an introductory customer service, making a provider change to attain a preferable rate with an equivalent policy a viable idea, but another issue arises in the case of a policy upgrade. Insurers will typically be very slow to offer immediate full cover under a policy that is significantly more valuable than before to protect themselves from fraud.

Another effect of an insurer granting full benefits to new clients is adverse selection, which would increase the company’s rate of high-risk subscribers, payouts, policy costs, and eventually, policy cancellations. For these reasons, you should expect to wait two full months before your new level of cover kicks in, and in the case of a person with health concerns or a physical occupation, this may be time that is ill-advised to gamble with, you can read more here.

Takeaway

Overall, the ability to switch providers can give you flexibility and the freedom to seek out the best medical coverage at the best price in theory. Nevertheless, complications such as waiting periods and partial benefits may mean the practice of switching providers can prove a risky proposition.

As always, be sure you do your due diligence: Find out as much information as you can. Ask around: Contact your colleague, partner and family members and ask them about their experience with the health coverages. Before you take any actions, please consider to consult with the right organization, so you can act accordingly with confidence.