When was the open enrollment deadline in your state?
In most states, including all that use HealthCare.gov, open enrollment for individual health insurance effective Jan. 1, 2019 ended on Dec. 15, 2018.
Enrollment deadlines differ for the following states and the District of Columbia:
- California1– Jan. 15, 2019
- Colorado2– Jan. 15, 2019
- Massachusetts3– Jan. 23, 2019
- Minnesota4– Jan. 13, 2019
- New York5– Jan. 15, 2019
- Rhode Island6– Dec. 23, 2018
- Washington DC7– Jan. 31, 2019
What happens if you missed open enrollment? Can you still get health insurance after open enrollment? If so, how?
Fortunately, missing open enrollment doesn’t mean you have to go without coverage for the year ahead. You have a few options, depending on your situation. This article will highlight three of them:
1. Apply for special enrollment
If you’ve recently experienced a life-changing situation, you may be eligible for special enrollment—the only way to buy ACA-qualifying (major medical) individual health insurance outside of the annual open enrollment period established under the Affordable Care Act (ACA).
Qualifying life events for special enrollment include, but are not limited to, the following8:
- Loss of health coverage– This includes losing your job-based plan or aging off a parent’s plan.
- Changes in your household– This includes getting married or divorced, having a baby or adopting a child, or experiencing a death in the family.
- Changes in residence– This includes moving to a new ZIP code or county, moving to or from the place you attend school, or moving to or from a shelter or other transitional housing.
These are only a few common examples. There are other circumstances that could make you eligible for special enrollment. HealthCare.gov provides more information about qualifying life events for special enrollment and the documents needed to confirm your eligibility.
If you think you qualify for special enrollment, don’t wait! Special enrollment periods are limited to a specific time period surrounding a qualifying life event.
Is special enrollment right for you?
You may want to consider buying health insurance through special enrollment if you:
- Have recently experienced a qualifying life event
- Want comprehensive, ACA-compliant health insurance coverage
- Need guaranteed issue health insurance
- Qualify for and want to take advantage of an Obamacare subsidy – use our calculator to estimate your subsidy
Are you eligible for special enrollment?
You can apply for a special enrollment period through your state’s health insurance exchange. Need help? Contact your state’s exchange or a health insurance agent for assistance.
2. See if you can get another form of minimum essential coverage
Individual major medical health insurance is only one form of minimum essential coverage. Examples of additional forms of ACA-compliant coverage include the following9:
- Employer-sponsored health insurance
- The Children’s Health Insurance Program (CHIP)
- Student health plans
Is another form of minimum essential coverage right for you?
As mentioned above, there are many types of minimum essential coverage. They have their own eligibility criteria, enrollment deadlines, and benefits associated with them.
If you don’t qualify for a special enrollment period for individual health insurance, determine that you’re ineligible for alternative health insurance such as short-term medical or hospital insurance (or decide it doesn’t meet your needs), you may want to see if there’s another form of minimum essential coverage available to you.
Are you eligible for another form of minimum essential coverage?
You will need to apply for coverage through the provider or program you’re interested in.
3. Get alternative health insurance
The ACA requires most individuals to have health insurance that’s considered minimum essential coverage. However, in 2019, the federal tax penalty for going without minimum essential coverage will go away.10 (Some states have implemented, or will implement, their own state-based health insurance mandates and penalties.)
These types of policies do not qualify as minimum essential coverage; however, you can apply for them year-round. They include a range of benefits for unexpected medical expenses related to injuries and illness, but they do have coverage limitations for pre-existing conditions..
As with individual major medical insurance plans, you can choose from deductible and coinsurance amounts to and select optional benefits to obtain a monthly premium and level of coverage that feels right for you.
However, unlike major medical, alternative health plans are not guaranteed issue, so you have to qualify in order to enroll.
Is alternative health insurance right for you?
You may want to check into alternative health insurance if you:
- Don’t qualify for a special enrollment period and open enrollment has ended
- Are not eligible for another form of minimum essential coverage such as Medicare or Medicaid
- Are okay with fewer healthcare benefits in exchange for potentially lower monthly premiums
- Don’t want a comprehensive health insurance policy
- Are able to qualify for enrollment
Are you eligible for alternative health insurance?
The only way to determine your eligibility is to apply for a policy. You may be denied coverage based on health history or face exclusions for pre-existing conditions.
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Prefer to speak to someone in person first? Call us at 866-278-1464 to speak with a licensed agent and learn more.
What to do if your health insurance begins after January 1
If you live in a state that has extended their open enrollment period, you may be uninsured for a short period of time if you enroll after December 15.
Consider applying for short-term health insurance to secure benefits that help pay for unexpected medical expenses between when your 2018 policy terminates and your 2019 policy begins.
Short-term health insurance is temporary coverage that lasts as few as 30 days, and up to 364 days in some states. (It is not available in all states. Learn more about short-term medical availability by state.)
Short-term policies provide a range of benefits to help pay for unexpected healthcare expenses. Additionally, short-term policies:
- Are available year-round
- Can begin as soon as the day after you are approved for coverage
- Can be tailored to your needs in terms of deductible, coinsurance and other plan options
- Are not guaranteed issue and do not cover pre-existing conditions
- Do not include essential health benefits like preventive care
- May be applied for online—and enrolled in online, if your application is approved
What happens if you miss open enrollment at work?
If you missed your opportunity to enroll in job-based health insurance during your company’s open enrollment period, speak with the person who coordinates your employer’s benefits program to learn about your options.
Summary + next steps
You’ve learned how to get health insurance after open enrollment. Now consider the options discussed above, determine which you’re eligible for, and begin the application process.
Here are 4 ways to get started:
- Visit HealthCare.gov for special enrollment.
- Research alternative health insurance.
- Call us 866-278-1464 to speak with a licensed agent.
- Find a local agent to help you navigate your options and the application process.