Insurance

Health Insurance Options if You Missed Open Enrollment

3 Mins read

Maybe it’s because you’re healthy and rarely go to the doctor.

Maybe you lost your job but the annual Open Enrollment period has passed.

Maybe it is because you aged out of your parent’s insurance and the premiums for a new policy gave you sticker shock.

Or you inadvertently missed the deadline.

Whatever the reason, if you didn’t buy health insurance for 2021 during Open Enrollment, you still have options.

In most states, the enrollment deadline was December 15, for coverage beginning January 1, 2021. If you missed that deadline, you might have to wait until the next Open Enrollment period to purchase individual health insurance. However, you still have a few options for coverage this year. Below are some guidelines for individual health insurance purchased privately or through a state insurance exchange. (For information on employer-based group plans, check with your employer.)

Does Your State Have Extended Enrollment?

If you live in one of the 10 states with extended open enrollment periods, you’re in luck. The following states have a deadline of January 15 or later:

  • California
  • Colorado
  • Massachusetts
  • Minnesota
  • Nevada
  • New York
  • New Jersey
  • Pennsylvania
  • Rhode Island
  • Washington
  • Washington, D.C.

Investigate Special Enrollment Periods

Under certain circumstances, you can buy health insurance outside of the open enrollment period. A life change, such as losing your insurance, qualifies you for a special enrollment period (SEP) which gives you 60 days to purchase new health coverage. For example, if you lose your health coverage on January 30, you have until March 30 to apply for new insurance. (Employer-based coverage may have a 30-day SEP.)

Last year, due to the Coronavirus emergency, 52 percent more consumers used a SEP to enroll through HealthCare.gov than in 2019, according to the Department of Health and Human Services.

Qualifying events for a special enrollment period include:

  • Getting married or divorced;
  • Having a baby or adopting a child;
  • Losing your insurance coverage due to leaving a job or losing a job, or losing coverage through a family member;
  • Moving to a new county or state

During a special enrollment period, you are eligible for the same coverage options as during open enrollment. If you don’t enroll in insurance by the end of the SEP, you will need to wait until the next open enrollment period or purchase short-term health insurance to cover the gap.

Consider Short-Term Health Insurance

Short-term health insurance is coverage lasting up to 364 days which can be purchased outside of the open enrollment period. You can reapply for coverage for up to 36 months. Short-term plans offer:

  • Affordable premiums
  • Quick application process
  • Flexible terms

Some consumers choose short-term insurance as a safety net while waiting for the next open enrollment period. Others prefer these policies due to their low cost compared to regular health insurance. However, short-term plans have limited benefits. Unlike Affordable Care Act plans, they do not cover treatment for pre-existing conditions or maternity care, among other things.

For more information or quotes on short-term health insurance, it’s helpful to work with a licensed, unbiased agent who can review options and costs with you.

When shopping for a short-term plan, consider the following:

  • Your costs, including the deductible, percentage of costs you pay after the deductible, and the maximum out-of-pocket costs;
  • The lifetime benefit maximum;
  • The network and if it includes your doctor and hospital;
  • Whether or not prescriptions are covered;
  • Health services the plan does and does not cover

Benefits of Short-Term Insurance

These plans work best if you are in good health and do not normally require health services or prescriptions. They protect against expensive costs such as emergency care or hospitalization. Short-term plans can provide peace of mind against high health care costs for anyone who is waiting for the next open enrollment period.

However, most plans do not cover mental health care, substance abuse or maternity care.

States with Additional Restrictions

Several states limit short-term plans to a few months while a few do not allow them at all.

  • No short-term plans: Five states do not allow short-term plans: California, Hawaii, Massachusetts, New Jersey and New York.
  • Six-month max: Colorado and Illinois have six-month limits on short-term plans.
  • Three months only: Five states and the District of Columbia allow three-month plans with no renewals: Delaware, Maryland, New Mexico, Vermont and Washington.

If you missed the open enrollment period for individual insurance health insurance, there are still ways to get coverage now:

  • Double-check your state’s deadline in case your healthcare exchange is still open;
  • Look into whether you qualify for a special enrollment period;
  • Research a short-term policy that will work for you.

There are still options to protect yourself and your family.

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