Obtaining Health Insurance If You Missed Open Enrollment

Whether you have health insurance through your employer, or you purchase it from a provider, there is usually an open enrollment period in which you can purchase a plan or make modifications to an existing plan. For those who do not have insurance through work, the open enrollment period for the federal and state public exchanges to sign up for health insurance in 2019 has already passed. So, what do you do if you need health insurance, but you missed open enrollment? Health insurance

If you need to obtain health insurance during a time of year that is outside the open enrollment period, there are some options that may work for you:

You May Have a Qualifying Life Event: Although the open enrollment period for the public health exchange is in the fall, individuals are allowed to enroll in or make changes to their health plan any time of the year if there is a major event in their life or a special circumstance. This is known as a “qualifying life event”. Some of the circumstances that may be considered qualifying life events include:

  • Getting married or getting divorced;
  • Having or adopting a baby;
  • Losing your job/losing the coverage you had through your employer;
  • Expiring COBRA coverage;
  • Turning 26 and aging off of your parents’ health insurance plan;
  • Moving to an area with different health insurance options;
  • Changes in income or household status that may impact your eligibility for certain government health care programs;
  • Being involuntarily cancelled by your current health insurance provider.

This list covers many of the common life circumstances that may create the need for health insurance outside of the open enrollment period. There is one notable exception, however. If you cancelled your current health insurance voluntarily, or you were cancelled because you did not pay your premiums, this is not considered a qualifying life event.

If you are eligible for coverage through the public exchange due to a qualifying life event, you usually have 60 days from the date of that event to enroll in a health plan. This is known as your “special enrollment period.” If you miss the enrollment deadline, you will need to wait until next fall when open enrollment starts again.

Insurance through Medicaid/CHIP: Certain individuals may qualify for coverage through Medicaid or Children’s Health Insurance Program (CHIP). These programs are administered by the states, and eligibility guidelines vary depending on where you live. Individuals with lower incomes, disabilities, the elderly, and children are the most likely to qualify for these programs. If you are not sure about your eligibility for Medicaid or CHIP, it does not hurt to apply. These programs have no open enrollment period, so they are available year-round.

Short-Term Health Insurance: If you are going through a transitional period, you may want to consider a short-term health plan. Short-term plans run for specified periods of time, have no coverage requirements, and they are not required to be in compliance with the Affordable Care Act (ACA). These plans help address temporary health insurance needs, such as:

  • Those who are between jobs;
  • Temporary or seasonal workers;
  • Recent college graduates who are waiting to obtain employment;
  • Those who are employed and waiting for their probationary period to end to become eligible for their employer’s group health plan;
  • Those who are waiting for the next open enrollment period to obtain insurance on the public exchange.

Private Health Insurance Plans: For those who missed the open enrollment deadline, or they are not able to find a plan on the public exchange that suits their needs, a private health insurance plan might be a good option. Private plans are purchased directly from a health insurance company, and oftentimes, you can find a more suitable plan this way. Private health plans tend to work well for individuals in the following circumstances:

  • Self-employed;
  • Employed, but your employer does not offer a group health plan;
  • Your group plan from work does not cover spouses and/or dependents;
  • You need a plan with lower premiums than what you are currently paying.

Speak with an Independent Insurance Broker to Discuss your Options: If you missed the open enrollment period to purchase health insurance through the public exchange, you still have options. To find out which option is best for you, start by speaking with an independent health insurance broker. Independent brokers have access to several of the top insurers in your state, and because they are not captive to anyone particular insurance carrier, they are able to shop freely and help you find the plan that best suits your needs and budget.