How to get Health Insurance outside of Open Enrollment?

A Guide for the Uninsured

Health insurance enrollment is only open for a limited time each year. Outside of open enrollment, you may have to wait until the next year to sign up for coverage unless you qualify for a special exception.

If you can’t enroll in health insurance during open enrollment or if your circumstances change, you might be left uninsured. If that’s the case, getting an insurance plan can be challenging—unless you know where to look

There are several ways to get covered when you aren’t able to sign up during regular registration periods. Depending on your situation, one of these options may be right for you:

Check if you’re eligible for a Special Enrollment Period

Special Enrollment Periods (SEPs) allow people who have Special circumstances to enroll in coverage outside of Open Enrollment. While there are several circumstances that qualify for an SEP, health insurance companies have the final say in approving coverage outside of open enrollment. If you qualify, it’s important to act quickly to enroll in a plan since SEPs are time-sensitive. It’s important to note that certain life events qualify for a special enrollment period regardless of when you want to apply. Here’s a brief rundown of some common circumstances that may qualify you for a special enrollment period:

See if you qualify for a Private Medically Underwritten Plan

Outside of employer coverage, there are only 2 real ways to get full major medical health insurance. Public marketplace(ACA) and Private medically underwritten plans. Private coverage has no enrollment period since because being accepted on those plans are contingent with your current health status. If you can qualify, you can get access to a nationwide PPO network with unlimited doctors, low to zero deductibles, and better overall benefits at preferred rate. Since these plans are also not tied to the IRS, they are perfectly designed for the self employed and also those who do not qualify for government tax credits through the ACA.

Check if you’re eligible for Medicaid or CHIP

If you’re unable to get health insurance through your employer, and you don’t qualify for a special enrollment period, the next thing you’ll want to do is see if you qualify for coverage through Medicaid or CHIP. Eligibility for these programs are based on income and other factors. If you qualify for one of these programs, getting coverage is as simple as filling out an application and providing a few documents to prove your eligibility. If you qualify for Medicaid, you’ll be able to sign up for coverage through a special enrollment period. You’ll also have the option to apply for CHIP through a special enrollment period if you don’t qualify for Medicaid coverage.

You may be able to enroll in an employer-sponsored plan outside of Open Enrollment

If you work at a company with more than 50 employees, you have the right to enroll in the company’s health insurance plan outside of open enrollment. You can do this even if you’re not actively employed at the company. You may be able to extend your coverage for up to 36 months after leaving the company. However, there are certain circumstances that may prevent you from enrolling in your employer’s plan outside of open enrollment. Your employer, for instance, may require you to have worked for the company for a specific period of time before being eligible for coverage. If you don’t work for an employer offering health insurance, you can still get coverage through COBRA. Often, COBRA is more expensive than enrolling in health insurance through the Affordable Care Act. You’ll need to weigh the pros and cons of COBRA versus marketplace coverage to decide which option is best for you.

Short-Term Health Insurance

Short-term Health insurance plans are an affordable way to protect yourself from illness and injury if you have a gap in your coverage. Keep in mind, short-term coverage is only meant to bridge a gap between full major medical plans and are not meant to be kept for extended periods of time due to their lack of a true max out of pocket.

Summing up

There are a number of ways to get insurance if you missed open enrollment. Make sure you know if you qualify for a special enrollment period. Private health insurance is a great option to become insured outside of open enrollment.

Check out my other blog post regarding Open Enrollment Dates for Health Insurance for 2022 here!

Review all of your options to get insured today with health insurance advisor, Emmanuel Lopez at Top Tier Coverage today! Book a time here, text or call

757-281-8178