How to Get Health Insurance After Open Enrollment (3 Ways)

Sarah Sullivan
December 3rd, 2019 December 18th, 2018 |
Read time: 7 minutes

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November and December are a busy time of year as many people are gearing up for holiday celebrations. From food planning to gift-giving, coordinating schedules and decorating it’s easy to forget things, even something as important as open enrollment for health insurance!

Did you miss the Affordable Care Act (ACA) annual open enrollment period for health insurance this year?

For coverage beginning Jan. 1, 2020, the open enrollment period for most states is from November 1, 2019, to December 15, 2019.1

However, some states that operate their own exchanges have extended health insurance enrollment periods as follows:

  • California: Oct. 15, 2019 to Jan. 15, 20202
  • Colorado: Nov. 1, 2019 to Jan. 15, 20203
  • Massachusetts: Nov. 1, 2019 to Jan. 23, 20204
  • Minnesota: Nov. 1 to Dec. 23, 20195
  • New York: Nov. 1, 2019 to Jan. 31, 20206
  • Washington D.C.: Nov. 1, 2019 to Jan. 31, 20207

Check with your state exchange to confirm deadlines.

If you did miss open enrollment, what are your options? 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 may have a few options, depending on your situation. This article will highlight three of them:

Option 1: A Special Enrollment Period

If you’ve recently experienced a qualifying life event you may be eligible for special enrollment—the only way to buy individual ACA major medical health insurance outside of the annual open enrollment period.8

Qualifying life events for special enrollment include, but are not limited to:

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 60-day period from the time of the qualifying event.10

Is special enrollment right for you?

You may want to consider buying health insurance through special enrollment if you:

Do You Qualify for an Affordable Care Act Subsidy?

Use the ACA Subsidy Calculator to find out if you can get financial help if you enroll in ACA-qualifying major medical insurance. Learn more about subsidies.

Are you eligible for special enrollment?

To apply for a special enrollment period through the federal Marketplace (healthcare.gov) or your state’s health insurance exchange just begin the health insurance application process. Your eligibility for special enrollment will be assessed if you’re applying outside of the open enrollment period.

You may have to supply documentation to confirm that you’re eligible.11

Need help? Contact your state’s exchange, find assistance at healthcare.gov or speak to a health insurance agent.

Option 2: Other Minimum Essential Coverage

Individual major medical health insurance is only one form of minimum essential coverage (MEC). Examples of additional forms of ACA-compliant MEC include, but are not limited to:12

See a comprehensive list of health insurance that counts as minimum essential coverage.

Is other minimum essential coverage right for you?

As mentioned above, there are many types of minimum essential coverage. Each program has their own eligibility criteria, enrollment deadlines, and benefits associated with them.

If you qualify, one of these programs may be a good option for individual minimum essential coverage if you don’t qualify for an ACA special enrollment period.

Are you eligible for other minimum essential coverage?

You will need to apply for coverage through the provider or program you’re interested in.

Visit HealthCare.gov for examples of minimum essential coverage and to determine if you are eligible.

Option 3: Non-Qualifying Health Insurance

Even though the ACA’s individual mandate is still technically in tact, the federal penalty for going without coverage was eliminated effective January 1, 2019.13 Some states have implemented their own state-based health insurance mandates and penalties.

What does this mean for you?

If you missed the annual open enrollment period, you don’t have to worry about paying the federal penalty (a state penalty may still apply depending on where you live). But what do you do about health insurance? Should you just go uninsured and hope you don’t experience an injury or illness for which you need to seek medical care?

Rather than going uninsured, if you qualify, you may want to explore non-qualifying, limited benefit coverage like short term medical insurance. You can apply year-round in most states, however you must qualify in order to enroll since these policies are not guaranteed-issue.
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 plans don’t cover the essential health benefits like preventive care but may cover unexpected medical expenses related to injuries and illness. Short term health insurance also generally does not cover pre existing conditions. Policies tend to be highly customizable, so you can opt for more coverage for a higher premium.

Compare short term insurance costs and coverage.

Get a Short Term Medical Quote

Is short term health insurance right for you?

If you can get it, ACA-qualifying minimum essential coverage provides the most comprehensive coverage available. However, you may want to check into non-qualifying coverage 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 premiums14
  • Don’t want a comprehensive health insurance policy
  • Are able to qualify to enroll in a short term policy
  • Don’t need coverage for pre-existing health conditions

Are you eligible for short term health insurance?

The only way to know for sure if you’re eligible is to apply for a policy. Keep in mind you may be denied coverage based on health history.

Want Supplemental or Non-ACA Insurance?

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Is a short term policy enough?

If you’re worried about having enough benefits with a short term policy, you can also enroll in supplemental health insurance to access more benefits.

Hospital indemnity or medical gap insurance can help supplement your short term benefits. These policies will provide either a lump sum (gap policies) or fixed indemnity benefit (hospital policies) for covered healthcare services or critical illnesses. In some states, hospital indemnity insurance is only available as a supplement to an ACA-complaint major medical policy and may not supplement a short term policy.

Get a hospital indemnity insurance quote or a medical gap quote to locate plans near you and compare coverage and cost.

Dental insurance may help make preventive oral healthcare like regular teeth cleanings more accessible. Get a dental insurance quote.

Telemedicine services, prescription drug and other discounts may help make access to healthcare service providers more convenient, affordable or both, and may be a nice complement to a short term medical policy. Health and medical discounts are not insurance. Get a health and medical discount plan.

Facing a Temporary Coverage Gap?
If you live in a state that has extended their open enrollment period (see above), you may be facing a temporary coverage gap if you enroll in ACA coverage after December 15.

You may want to consider applying for short term health insurance to help with unexpected qualifying medical expenses between when your current policy terminates and next year’s policy goes into effect.

Short term policies can begin as soon as the day after you are approved for and you’ve paid your first premium. Policies can last for as few as 30 days. Get a short term medical quote to compare policies and costs.

Summary + Next Steps

In this blog post we discussed ways to get health insurance after open enrollment.

Consider the options discussed above, determine which you may be eligible for, and begin the application process.

Here are four ways to get started:

  1. Visit HealthCare.gov for special enrollment and to see if you could qualify for other minimum essential coverage.
  2. Research non-qualifying insurance like short term medical.
  3. Call 888-855-6837 to speak with a licensed health insurance agent.
  4. Find a local agent to help you navigate your options and the application process.
Originally Published On February 1st, 2016
Independence American Insurance Company and/or Madison National Life Insurance Company, Inc. may underwrite the products referenced on this website. Legal Disclaimers.

Footnotes

Get Health Insurance for 2020

Open enrollment is Nov. 1 to Dec. 15, 2019 in most states. Find out if you could qualify for an ACA subsidy.

 

ACA Subsidy Calculator

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