How to Get Health Insurance After Open Enrollment

Most commercial and government-sponsored health insurance plans have a specific enrollment period. However, if you miss it, there are some alternative options for getting health insurance.

These include a special enrollment period, opting for an insurance plan that is open throughout the year, e.g., CHIP or Medicaid, or applying for a short term insurance plan as you wait for the next open enrollment period for your preferred health insurance plan.

This article will discuss the various options for getting health insurance after open enrollment in detail.

I Missed Open Enrollment, What Should I Do – 5 Options Available

Apply for Special Enrollment Period

A special enrollment period is a time outside the regular open enrollment period when you can sign up for a health insurance plan. You may be eligible for a special enrollment period if you have a qualifying life event, such as:

• Getting married
• Having a baby or adopting a child
• Losing other health coverage (e.g., due to a job loss or a divorce)
• Moving to a new area that offers different health insurance options
• Loss of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
• Gaining citizenship
• Aging off a parent’s health insurance plan
• Leaving incarceration

If you have a qualifying life event, you generally have 60 days from the event date to enroll in a new health insurance plan. It’s important to note that you may need to provide documentation of your qualifying life event when you enroll.

If you are unsure if you are eligible for a special enrollment period, check with the Health Insurance Marketplace or your insurance provider. They will be able to tell you if you are eligible and help you enroll in a new plan.

Short Term Health Insurance

Short term health insurance, also known as short term medical insurance, provides coverage for a limited period of time, typically a few weeks to a few months. It is often used as a temporary solution for people between jobs, waiting for coverage to begin through a new employer, or transitioning between plans.

Short term health insurance plans are generally less expensive than traditional health insurance plans, but they also typically provide less coverage. They may not cover pre-existing conditions and have higher deductibles and out-of-pocket costs. They also may not cover preventive care, such as vaccinations and screenings, or certain services, such as mental health care or prescription drugs.

COBRA

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, is a federal law that allows you to continue your employer-sponsored health insurance coverage for a limited time if you lose your coverage. COBRA applies to employers with 20 or more employees and applies to group health plans, including medical, dental, and vision coverage.

If you are eligible for COBRA, you can continue your employer-sponsored coverage for a certain period, usually 18 to 36 months. You will be responsible for paying the full premium for your coverage, including the portion your employer used to pay. COBRA premiums are generally more expensive than the premiums for employer-sponsored coverage because you are paying the full cost of the coverage.

To be eligible for COBRA, you must have been enrolled in an employer-sponsored health insurance plan when you lost your coverage. You may lose your coverage if you are no longer employed, if your hours are reduced, if you lose dependent status (e.g., through divorce or death), or if you become entitled to Medicare.

If you are eligible for COBRA, you will receive a notice from your employer or the health plan explaining your COBRA rights and how to elect COBRA coverage. Carefully review the notice and make a decision about whether to elect COBRA coverage within the deadline specified in the notice.

If you have questions about COBRA or need help electing coverage, contact the Department of Labor’s Employee Benefits Security Administration for assistance.

Primary Care Health Insurance Membership

Primary care membership plans, also known as direct primary care or concierge medicine, are a type of health insurance alternative that provides access to primary care services for a monthly or annual fee. These plans typically do not cover hospital or specialty care, so it’s important to have a traditional health insurance plan in addition to a primary care membership plan to have comprehensive coverage.

With a primary care membership plan, you pay a fee to access primary care services, such as preventive care, routine check-ups, and treatment for common illnesses. These plans may offer lower out-of-pocket costs for primary care services compared to traditional insurance plans, but they do not cover hospital or specialty care.

Join a Health-Sharing Plan

Health-sharing plans are a type of alternative to traditional health insurance. They are not insurance plans and are not regulated by the government. Instead, they are membership organizations that pool money from members to help pay for medical expenses.

In a health-sharing plan, members agree to pay a monthly fee, or “share,” to help cover the medical expenses of other members. These plans typically have a list of medical expenses that are eligible for sharing, and members are responsible for paying their own medical expenses that are not on the list.

Note that health-sharing plans are not required to cover pre-existing conditions and may have other exclusions and limitations. They also do not have to follow the same rules and regulations as traditional health insurance plans, so they may not offer the same level of protection.

CHIP

The Children’s Health Insurance Program (CHIP) is a government-funded health insurance program for children in families with low to moderate income. Like Medicaid, CHIP does not have a specific open enrollment period. Instead, you can apply for CHIP at any time during the year.

To be eligible for CHIP, your child must be under the age of 19 and must not be eligible for Medicaid. Income and resource requirements for CHIP vary by state. Some states have expanded their CHIP programs to cover more children, so even if you do not think you are eligible, it’s a good idea to apply and see if your child qualifies.

To apply for CHIP, you can do one of the following:

• Contact your state’s CHIP agency and request an application.
• Apply online through your state’s CHIP website.
• Apply through the Health Insurance Marketplace. If your child is eligible for CHIP, they will automatically enroll in the program.

Eligibility for CHIP is determined on a case-by-case basis, so you will need to provide information about your income, resources, and other factors to determine if your child qualifies.

If you have questions about CHIP or need help applying, contact your state’s CHIP agency or the Health Insurance Marketplace for assistance.

Conclusion

If you miss the open enrollment period for your preferred health insurance plan through the marketplace or your employer, you may still be able to get health insurance coverage through other avenues.

A special enrollment period is suitable if you have a qualifying life event, while short term health insurance can be a temporary solution until the next enrollment. Alternatively, if you want more comprehensive coverage, consider insurance plans whose enrollment is open the entire year, e.g., Medicaid.