It’s not Open Enrollment. Can I still get health insurance coverage?


Each year, there is a three-month open enrollment period when anyone can sign up for a  healthcare plan on the Federal Marketplace. Open enrollment for 2016 coverage extended from November 1, 2015 to January 31, 2016. Now that this period is past, you must have either experienced certain “qualifying life events” within the last 60 days, or expect them to occur within the upcoming 60 days, in order to take advantage of a Special Enrollment Period (SEP).

The good news is that these qualifying life events are fairly extensive and cover many people’s situations!

You can buy health insurance right now if you have:

  • Lost job-based coverage: This applies to you even if you voluntarily left your job or decreased your work hours. It also applies if your job-based coverage does not meet current standards for value and affordability.
  • Lost coverage through an individual plan: This category includes losing your coverage due to circumstances like moving or no longer being a student. You don’t qualify under this category if you just stopped paying premiums, gave up on paperwork or voluntarily withdrew from your individual plan.
  • Changed your income: An increase in income may mean that you no longer qualify for Medicaid or premium-free Medicare Part A, while a decrease could mean that you now qualify for Medicaid, which allows year-round enrollment.
  • Lost coverage through a family member: If you’ve had health insurance through a family member’s policy, and have lost it due to death, divorce or no longer being a dependent, you qualify under this category.
  • Changed your household size: Have you gotten married, added a child to your household or had a child move out? You can enroll in a new insurance plan within 60 days of this event.
  • Moved: A new zip code often changes your eligibility for regional plans, and this counts as a qualifying life event.
  • Changed your citizenship status: If you have just become a U.S. citizen or have recently been released from incarceration, you have the chance to start over with new insurance.
  • Encountered exceptional circumstances: The Federal marketplace recognizes that life events are sometimes hard to categorize. Their extra list of possible exceptions lets you qualify for enrollment if you have been hospitalized, subject to domestic violence, natural disaster or insurance company misinformation.

Our licensed brokers are happy to help you gather the necessary paperwork to apply for a Special Enrollment Period under one of the qualifying life events listed above. Make an appointment today if you have any questions about the best healthcare options available for yourself and your family.

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