Summer Save Series: Medical Insurance After Open Enrollment

I Missed Open Enrollment. How Can I Get Health Insurance Now?

Open Enrollment for 2019 Affordable Care Act plans ended on December 15, 2018.  In most cases, you would need to wait until the next Open Enrollment period starts on November 1, 2019 to change your health insurance plan or enroll in a new one.  However, even after Open Enrollment has ended, there are a few ways to still get health insurance coverage.

These are:

  • Through a special enrollment period due to a qualifying life event

  • Under a short term medical plan

  • Through Medicaid or the Children’s Health Insurance Program (CHIP)

  • Note that you can purchase dental or vision insurance plans outside of Open Enrollment, so you can apply for one of these anytime.

Special Enrollment Periods and Qualifying Life Events

Certain life events qualify you for a special enrollment period.  A special enrollment period is a period of time (usually 60 days) during which you can buy a health plan, even if it’s outside the normal Open Enrollment period.  The events that trigger a special enrollment period are called qualifying life events.

Qualifying events for health insurance special enrollment include:

Losing your health coverage through a life event Examples of these life events include: getting a divorce, losing your job, losing your Medicaid or CHIP eligibility, or expiring COBRA coverage

Please note: If you voluntarily quit your health plan or are terminated because you didn’t pay your premiums, you are not eligible for a special enrollment period.

  • Getting married

  • Having or adopting a child

  • Permanently moving somewhere with different health insurance options

  • Ageing off your parent’s health insurance plan.

  • Having a change in income or household status that changes your eligibility for tax credits or cost-sharing reductions

  • Your plan being involuntarily canceled by your insurance company.

  • Health insurance special enrollment periods typically last for 60 days after the date of your qualifying event.

During this time, you can shop for health insurance on a private or public exchange. You’ll have the same plan options as you would during open enrollment, like copay plans, Health Savings Account (HSA)-compatible plans and a Young Adult plan. You may also have choices for dental plans and vision plans.

Be sure to purchase coverage during your special enrollment period. If you miss that period, you will have to wait until the next open enrollment period. However, you can buy a short-term health plan to cover yourself for a short period of time.

Enrolling in a Short Term Medical Plan

If you missed the ACA Open Enrollment deadline and do not qualify for Medicaid, CHIP or a special enrollment period, you might consider a short term health plan.

Some important things to consider regarding short term plans:

They do not commonly cover pre-existing conditions, and premiums can be based on your medical history. These plans are not guaranteed issue, so your application can be turned down.Regulations limit short term plans to 364 days in duration.They’re not available in every state.

Despite all this, if available where you live, short term plans can provide the security of health coverage and provide protection from catastrophic and unexpected healthcare emergencies.  They are worth researching if you’re otherwise unable to buy coverage through a special enrollment period or other means.

Getting Covered Under Medicaid/CHIP

Though costs, coverage, and other particulars may differ from state to state, all states have Medicaid programs to provide coverage to a variety of people, including those with lower incomes, people with disabilities, the elderly, pregnant women, families, and children.   CHIP was created to cover children in families that do not meet Medicaid income requirements.  In some states, pregnant women can be covered under CHIP.

Because Medicaid and CHIP programs can vary from state to state, you should contact your state’s Medicaid agency to see if you qualify and learn how to apply outside open enrollment.

Read more here