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Buying health insurance outside of Open Enrollment can be difficult, but it’s not impossible. Follow these steps to find the right health insurance plan for you.
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Introduction
If you need to buy health insurance outside of the Affordable Care Act’s open enrollment period, it’s important to understand your options. You may be able to find a plan through the federal or state marketplace, or you may be able to get coverage through an employer. You can also buy a private health insurance plan, but you’ll need to make sure it meets all of the ACA’s requirements.
What is Open Enrollment?
Open enrollment is the period of time each year when people can sign up for or make changes to their health insurance. The open enrollment period for 2020 coverage starts on November 1, 2019 and ends on December 15, 2019. If you don’t enroll in a plan by December 15, you can’t get 2020 coverage unless you qualify for a Special Enrollment Period.
When is Open Enrollment?
Open enrollment for 2019 health insurance plans starts November 1, 2018 and lasts until December 15, 2018. If you don’t enroll in a plan during open enrollment, you can’t buy individual health insurance for 2019 unless you qualify for a Special Enrollment Period.
How to Buy Health Insurance Outside of Open Enrollment
If you are looking to buy health insurance outside of the open enrollment period, there are a few things you need to know. The first is that you may have to pay a higher premium because you are not getting the benefit of the group rates that are available during open enrollment. The second is that you may not be able to get coverage for pre-existing conditions. If you are healthy, this may not be an issue for you. However, if you have a condition that needs to be covered, you may want to wait until open enrollment.
Special Enrollment Periods
If you experience a qualifying event, you may be eligible for a Special Enrollment Period to sign up for health insurance outside of the Open Enrollment Period. Depending on your circumstances, you may have 60 days before or 60 days following the event to enroll in a plan.
Qualifying life events that trigger a Special Enrollment Period include:
-Moving to a new state
-Losing other health coverage (for example, due to job loss, divorce, or the end of an insurance plan)
-Having a baby or adopting a child
-Turning 26 and no longer being eligible to stay on your parents’ health insurance plan
-experiencing certain changes in income that affect your eligibility for subsidies
If you think you might qualify for a Special Enrollment Period but are not sure, you can:
-check with your state’s marketplace
-contact the marketplace call center
-speak with an insurance agent or broker
Short-Term Health Insurance
Short-term health insurance plans are a type of health insurance that are designed to cover you for a short period of time, typically between 30 and 364 days. These plans are not required to provide all of the essential health benefits that are mandated by the Affordable Care Act (ACA), which means they may not cover things like maternity care, mental health care, or prescription drugs. They also are not required to provide coverage to people with pre-existing conditions.
If you need coverage for a short period of time and do not need all of the ACA-mandated benefits, a short-term health insurance plan may be a good option for you. These plans typically have lower premiums than plans that provide comprehensive coverage, but they also have higher out-of-pocket costs, so it is important to compare the costs and benefits of several different plans before enrolling in one.
Health Care Sharing Ministries
If you’re not able to buy health insurance during open enrollment, you may be able to join a health care sharing ministry. Health care sharing ministries are nonprofit organizations that help people team up and pay for their medical expenses.
How do they work? Members of a health care sharing ministry agree to share their medical expenses with other members of the group. This means that when one member has a medical bill, the other members pitch in to help pay for it.
Not everyone is eligible to join a health care sharing ministry. For example, you generally have to be part of a religious group that shares your views on religion and medicine. And, you usually have to agree to live a healthy lifestyle and not use tobacco products.
What are the benefits of joining a health care sharing ministry? Members of these ministries typically pay less for their healthcare than people who have traditional health insurance. In addition, most members feel good about helping others in their community pay for their medical bills.
What are the drawbacks? Health care sharing ministries don’t have to follow all of the rules that apply to regular health insurance plans. That means they might not cover pre-existing conditions or certain types of medical procedures. In addition, if you get sick or have an accident, you might have to pay all of your medical bills yourself until enough members have joined the plan to cover your expenses.
Conclusion
If you find yourself in a special enrollment period, take advantage of it by shopping around for the best health insurance plan. Outside of open enrollment, your options may be more limited, but you can still find good coverage if you know where to look. You may have to pay a little more for your premium, but it’s worth it to have the peace of mind that comes with knowing you’re covered.
