Buying a Health Plan after Open Enrollment

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

The Open Enrollment Period for Individual and Family plans starts November 1 and ends January 15. A plan's effective date may vary based on the date an application is submitted. In most cases, you would need to wait until the next Open Enrollment Period. However, even after the Open Enrollment Period has ended, there are some ways to still get health insurance now.

These are:

• Through a Special Enrollment Period
• Under a short-term medical plan
• Through Medicaid or the Children’s Health Insurance Program (CHIP)

Note: You can purchase a standalone dental or vision insurance plan outside of the Open Enrollment Period. 

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 life events include:

• Losing your health coverage through a life event
  
  • Examples 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
• Aging 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 the Open Enrollment Period, like copay and Health Savings Account (HSA) compatible plans. You may also have choices for dental 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 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:

• Short-term plans do not meet the Affordable Care Act’s requirements for minimum essential coverage.
• 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 182 and 364 days in duration.

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 the Open Enrollment Period.