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If you missed the open enrollment period for health insurance, there are still ways you can get coverage
How to Get Health Insurance After Open Enrollment
The Basics
So, open enrollment has passed and you’re without health insurance. Don’t panic just yet—there are still options available to you. While it’s true that the open enrollment period is a specified time during which individuals can select a health insurance plan, it’s not the only time when one can acquire coverage.
Typically, this period takes place once every year, and outside of it, enrolling in or changing your marketplace plan can be difficult unless you qualify for special enrollment periods. These periods are triggered by life events such as losing other health coverage, moving, getting married, having a baby, or adopting a child.
Let’s say, for instance, Sarah recently lost her job and with it, her employer-sponsored health insurance. Fortunately for Sarah, losing her health coverage qualifies her for a special enrollment period, allowing her to enroll in a new plan outside the typical open enrollment period.
- Understand the basics of open enrollment and special enrollment periods.
- Identify your individual circumstances and how they can affect your ability to get coverage.
- Explore possible options for securing health insurance.
- Research different insurance plans to determine which one suits your needs best.
- Contact an insurance broker or navigator if needed.
- Remember to stay calm and evaluate your options carefully to choose an appropriate plan.
Your Special Enrollment Period
As mentioned earlier, even if you missed the open enrollment period, certain life events might grant you a special enrollment period. These life events, also known as qualifying events, allow you the opportunity to change or apply for health insurance outside of the standard open enrollment timeframe.
Your special enrollment period typically lasts 60 days from the day of your qualifying event. It’s crucial to take action within this timeframe because once the special enrollment period ends, you’ll have to wait until the next open enrollment period unless another qualifying event occurs.
Take, for instance, John who recently got married. This marriage is considered a qualifying event, giving John and his spouse a 60-day window from their wedding date to enroll in a new health insurance plan or change existing coverage.
- Identify potential qualifying events in your life.
- React swiftly once a qualifying event takes place.
- Apply for health insurance during your special enrollment period.
- Gather all necessary documentation proving the occurrence of your qualifying event.
- Keep track of all deadlines to avoid missing out on possible coverage.
- If possible, seek advice from experts about your situation and options.
Utilizing Short-Term Health Insurance
If you’ve passed the open enrollment period and don’t qualify for a special enrollment period, then you might need to look into short-term health insurance. Though it’s not an ideal long-term solution, it can provide valuable financial protection in case of unexpected injuries or illnesses.
Whereas typical health insurance plans are designed to provide comprehensive coverage, short-term plans usually cover only emergency healthcare needs. Furthermore, they usually don’t include coverage for preventative care or pre-existing conditions.
Consider Alex, who missed the open enrollment period and didn’t qualify for a special enrollment period. He chooses a short-term health insurance plan that covers him for three months, ensuring he has some level of coverage in the interim period before the next open enrollment.
- Weigh the pros and cons of short-term health insurance.
- Understand what’s covered and what isn’t in short-term plans.
- Ensure that the plan fits within your budget.
- Remember this is a temporary solution.
- Timely follow-up on when the term of short-term insurance ends.
- Reach out to health insurance providers to learn about their available short-term plans.
Medicaid or Children’s Health Insurance Program (CHIP)
If you’re low on income, pregnant, a child, an elderly adult or a person with a disability, you might qualify for Medicaid or the Children’s Health Insurance Program (CHIP). Both these programs provide free or low-cost health coverage and function outside of the open enrollment period.
Medicaid and CHIP cover a broad range of benefits while eligibility depends on your income level, family size, and certain disabilities. They are invaluable resources to those who need them, so it is worth investigating if you are eligible.
Imagine Laura, a single mother of three children. She doesn’t earn enough to afford private health insurance, but her children qualify for CHIP. This program provides her children access to necessary medical attention without causing financial hardship.
- Assess whether you or your family members can apply for Medicaid or CHIP.
- Understand all the requirements and benefits associated with these programs.
- Apply promptly once you find out you’re qualified.
- Keep track of any updates or changes made in these state-run programs.
- Make efficient use of the services provided under these programs.
- Remember that applying will not hinder your chances of getting other insurance later.
Catastrophic Health Insurance Plans
A catastrophic health insurance plan is designed for people under 30 and some low-income people who are exempt from other ACA plans. This type of insurance generally has lower monthly premiums but higher out-of-pocket costs.
These plans offer three primary care visits covered per year before you meet your deductible. They also protect against worst-case scenarios like major accidents or illnesses. However, they don’t cover routine healthcare expenses.
Look at Mike, a healthy 25-year-old man who doesn’t visit the doctor often. He chooses a catastrophic plan, which gives him low monthly premiums and coverage in case of serious accidents or illnesses.
- Analyze your health needs and financial situation to determine if a catastrophic plan is right for you.
- Understand the limits of catastrophic plans.
- Evaluate whether the cost savings is worth the risk.
- Ensure that you meet the eligibility criteria set by the ACA.
- Plan your budget properly to accommodate possible high out-of-pocket costs.
- Contact your preferred insurance provider to inquire about their catastrophic plan offerings.
Getting Health Insurance through Your Spouse’s Plan
One more option for obtaining health insurance after the ending of open enrollment is joining your spouse’s insurance plan. Many employers provide the option for employees to add their spouse onto their health insurance.
If your spouse has access to employer-sponsored health insurance, this could be an efficient way to get insured outside the open enrollment period. However, adding a family member will likely increase the cost of the health insurance premiums, so make sure to consider its affordability before deciding on this option.
Imagine Angela, whose husband Barry has an employer-sponsored healthcare plan. Angela just started her own business and is currently without health insurer. She can opt to join Barry’s plan and ensure she maintains continuous coverage during her venture.
- Find out if your spouse’s employer offers health insurance benefits for spouses.
- Consider the costs associated with being added to your spouse’s plan.
- Compare the benefits offered under your spouse’s plan with other available options.
- Understand the process and requirements to be enrolled in your spouse’s scheme.
- Maintain a good line of communication with your spouse’s employer or insurance provider.
- Don’t shy away from asking for help or advice from health insurance professionals.
Coverage through Parents’ Health Insurance
The ACA allows adults up to the age of 26 to stay on their parents’ health insurance plans. If you’re under 26 and your parent has a healthcare plan, this could be a suitable option to secure heath insurance even after the open enrollment period.
Being covered by a parent’s policy usually provides the same benefits as if bought independently, including coverage for maternity, mental health services, and other important benefits. Typically, you can join or remain on a parent’s plan even if you are married, not living with your parents, attending school, or not financially dependent on your parents.
Take Kate, a 22-year-old recent college graduate who is looking for a job. Since she can’t afford an individual health insurance policy at the moment, she opts to remain on her mother’s insurance plan until she secures employment.
- Check whether you’re eligible for coverage under your parent’s plan.
- Discuss this option with your parents to make sure they’re okay with it.
- Compare the benefits of being included in your parent’s plan against other alternatives.
- Remember to switch to your own insurance before you turn 26 if you choose this option.
- Review all documentation related to your health insurance plan carefully.
- Ask for assistance from an insurance advisor if necessary.
Detailed Summary
Action | Considerations |
---|---|
Special Enrollment Period (SEP) | Occurs due to life events which cause changes in health coverage; lasts for 60 days. |
Short-Term Health Insurance | A temporary solution when open enrollment is missed; often lacks comprehensive coverage. |
Medicaid or CHIP | Available all year round for eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. |
Catastrophic Health Insurance Plans | Designed for people under 30 and some low-income individuals exempt from other ACA plans; protects against worst-case scenarios. |
Spouse’s Plan | An option to get insured outside the open enrollment period if spouse has access to employer-sponsored health insurance. |
Parents’ Health Insurance | If you’re under 26, you can stay on or join your parents’ health insurance plan regardless of marital status, residency, school status, and financial dependence. |
Navigating the world of health insurance can be tricky, especially when straying from the traditional path of open enrollment. But fear not—there are a number of alternatives available, should you miss that window. Whether qualifying for a special enrollment period, opting for short-term insurance, exploring government programs, or tagging along on a significant other’s or parent’s plan, remember that options exist. That way, you can still secure your peace of mind, knowing that you’re covered whatever comes your way!