I Missed Open Enrollment and Need Health Coverage — What Are My Options?

The next official ACA Open Enrollment period isn’t slated to begin until November 1. But depending on your circumstances, you may not have to wait that long to obtain coverage.

Qualifying Life Events and Special Enrollment Periods

Sometimes our circumstances change, and if they change due to specific events, you and your dependents may be able to secure health insurance through a Special Enrollment Period. When this occurs, it is called a Qualifying Life Event, otherwise referred to as a QLE.

There are several types of Qualifying Life Events that may grant you a Special Enrollment Period. Some of the most common examples include:

• Loss of health coverage
  • Losing existing health coverage – including job-based, individual, and student plans
  • Losing eligibility for Medicare, Medicaid, or CHIP
  • Turning 26 and losing coverage through a parent’s plan
• Changes in household size
  • Getting married or divorced
  • Having a baby or adopting a child
  • Death in the family
• Changes in residence
  • Moving to a different ZIP code or county
  • A student moving to or from the place they attend school
  • A seasonal worker moving to or from the place they both live and work
  • Moving to or from a shelter or other transitional housing
• Other qualifying events
  • Changes in your income that affect the coverage you qualify for
  • Gaining membership in a federally recognized tribe, or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming a U.S. citizen
  • Leaving incarceration (jail or prison)
  • AmeriCorps members starting or ending their service

Non-ACA Health Plans

Haven’t experienced a QLE but still need health coverage? A non-ACA health plan could be the answer. Also referred to as Short Term Medical Plans, recent legislative changes have loosened the restrictions surrounding these plans and have increased their appeal.

Previously, a Short-Term Medical plan could only provide coverage for up to 90 days. But due to recent regulatory changes, these plans can now be continued for up to a year.  Additionally, in some cases, applicants may now renew their plan for up to three years.

Because Short-Term Medical Plans are considered non-ACA health plans, it is worth noting that they may not cover all that an ACA health plan would. For example, applicants could be denied coverage due to a pre-existing medical condition, maternity care may not be covered, and there could be an annual dollar limit on coverage. However, these plans are also typically less expensive than ACA plans and could be a good alternative for individuals seeking more affordable options.

Know Your Options

Do you think you may qualify for a Special Enrollment period? Are you interested in hearing more about non-ACA plans and if they may be the right fit for you? Our benefits counselors are always on hand to help answer your questions and guide you in the direction that will make the most sense for your unique needs.

Visit your association website to learn more about the health insurance offerings that may be available to you, or schedule an appointment with one of our licensed benefits counselors today.