You need health insurance, but you’re not sure how to get it. You did a quick Google search and saw that Open Enrollment ended on Jan. 31 — and it won’t reopen until November 2018! If you missed this short window of time to sign up for a plan, can you still get covered?
The answer lies in three words: Special Enrollment Period.
What Is The Special Enrollment Period?
The Special Enrollment Period is a window of about 60 days when you can buy health insurance outside of Open Enrollment. However, Special Enrollment isn’t available to everyone. To be eligible for Special Enrollment, you must experience a qualifying life event.
What Is A Qualifying Life Event For Health Insurance?
A qualifying life event is considered a life-changing event for you or your family. Here’s what the government considers a qualifying event for health plans that comply with the Affordable Care Act (also known as Obamacare):
You Lose Other Health Insurance Coverage
Maybe you quit or got laid off. Maybe you’re still employed, but your employer reduced their benefits. If you need health insurance until you find a new job or qualify for employer-sponsored coverage, you can use Special Enrollment to enroll in an individual or family plan.
You Move Permanently
Health insurance laws vary by state. Plus, your previous health insurance provider might not offer plans in your new area. Whether you move across town or to a new state, you can shop for health care coverage during the Special Enrollment Period.
You Have A Baby Or Adopt A Child
Your needs change drastically when you have a child. Special Enrollment gives you 60 days to find a plan that covers the right maternity care for you and your family. (Plus, your new child will be covered under their mother’s insurance plan for the first 30 days!)
You Get Married
Once you’re married, you can add your spouse to your plan (or be added to their plan).
You Get Divorced
If you were covered under your former spouse’s health insurance plan, you can enroll in a new plan. If your spouse was covered under your plan, you can use Special Enrollment to remove them as a dependent and consider a new plan.
You Start A New Job
If your new employer doesn’t offer health insurance that meets Obamacare standards, you can buy your own coverage.
You Or Your Dependent Turns 26
Under the Affordable Care Act / Obamacare, parents and guardians can include children as dependents up to age 26. Once you or your child turns 26, you qualify to enroll in a new plan during Special Enrollment.
Your Income Changes
A change in income will affect which type of plan you can afford. It can also make you eligible for government subsidies that help you pay for your insurance costs.
Your Current Plan Is Up For Renewal
If you’ve had the same plan for years, your new plan might renew outside the annual Open Enrollment Period. You can renew your plan (or find new coverage) during Special Enrollment.
You’re A Domestic Abuse Survivor
If you need to enroll in a plan independent of your abusive partner, you can do so through the Special Enrollment Period.
You Experience An Exceptional Circumstance
If you had an unexpected hospitalization or suffered through a natural disaster (that kept you from enrolling), you can qualify to change or buy a plan that helps cover your medical expenses.
You Become A U.S. Citizen
Once you become a citizen, you qualify for health insurance that meets Obamacare standards.
You’re American Indian
The Indian Health Care Improvement Act allows American Indians to enroll in a plan anytime of the year. (In other words, Special Enrollment for American Indians is year-round.)
All the events listed above are considered Special Enrollment qualifiers because they’re tied to at least one of three factors: your access to health insurance coverage, the type of coverage you need, or the number of people you need to cover. If you lose coverage, qualify for coverage, become a dependent, or gain a dependent, you could be eligible for Special Enrollment.
When Do I Qualify For Special Enrollment?
If you experience a qualifying life event, you typically have 60 days to enroll in an Obamacare-compliant health insurance plan. And here’s even better news: in most cases, your Special Enrollment Period can start before your qualifying life event begins. That way, you can be covered on the day of your event (like a marriage or birth), so you don’t risk having any gaps in your health care coverage.
What If I Don’t Qualify For Special Enrollment?
Leave that answer to the experts! Even if you don’t think you’ve had a qualifying life event, an agent can help you find out.
Sign Up For A Plan Today!
Major life changes don’t have a timetable. To prepare for the unexpected, talk to a licensed insurance professional at Regency West Insurance Services. A friendly agent can help you find an affordable plan that suits your needs and budget — no matter what life throws your way!
Sources:
https://www.healthinsurance.org/obamacare/qualifying-events-that-can-get-you-coverage
https://www.healthcare.gov/sep-list