open enrollment for health insuranceWithout a doubt, health insurance is essential. When you have coverage, you can easily receive routine checkups, visit a specialist, fill prescriptions, or take care of any serious ailment. Nevertheless, if you are looking forward to enrolling in health insurance outside of Open Enrollment, you do not have to wait.

In this article, we want to answer the question of When Can You Change Health Insurance Outside of Open Enrollment? Moreover, we want to provide insight about how Open Enrollment works, who is qualified for coverage outside of an Open Enrollment Period (OEP), and why it was created.

What is Open Enrollment?

One of the main changes under the Obamacare (Affordable Care Act) is the introduction of Open Enrollment. This is a set period of the year when you can purchase Marketplace health insurance or make changes to your health insurance plan. In most states it is mostly from November 1st – December 15th.

Why does Open Enrollment Exist?

Prior to the enactment of the Affordable Care Act, insurance companies could increase insurance premiums or deny coverage to a person based on their medical history. The Affordable Care Act made it illegal for insurance companies to deny coverage due to any type of pre-existing condition or someone’s medical history. 

To avoid a situation where a person only gets health insurance during the month, they know they require medical care, the Affordable Care Act established an Open Enrollment Period to help people get health insurance annually.

When someone makes the payment for their monthly insurance premium, it goes into a large pot (where everyone – healthy or sick– contributes). That gives insurance companies the capacity to put that money towards medical care when a client requires it.

What is a Special Enrollment Period?

2021 Open EnrolmentNow let us tackle the big question that most people often ask “Can one enroll for health insurance outside of Open Enrollment?”

Notably, you will require to experience a qualifying life event that triggers a Special Enrollment Period (SEP) to enroll in health insurance outside of an Open Enrollment Period. In most instances, you can enroll up to 60 days after the event if you experience a qualifying life event.

What is a Qualifying Life Event?

A qualifying life event is a substantial change in life that makes you eligible to enroll outside of an Open Enrollment Period. Typically, this type of major life event includes becoming a citizen, losing coverage, getting married, or having a baby.

Below is a detailed list of the various types of qualifying life events:

Lost job-based coverage 

This mainly applies to you even if you willingly left your job or reduced your work hours. In addition, it also applies if your job-based insurance coverage does not meet current standards for affordability and value.

Lost Coverage Through a Family Member 

 You qualify under this category if you previously had health insurance through a family member’s policy and lost it because of divorce, death, or no longer being a dependent.

Lost Coverage Through an Individual Plan 

This category involves losing your coverage because of circumstances like no longer being a student or relocating. You do not qualify under this category if you stopped making premiums payments, voluntarily withdrew from your individual plan, or gave up on paperwork.

Changed your Income 

 Short term health insuranceA rise in income may imply that you no longer qualify for premium-free Medicare Part A or Medicaid. A reduction could mean that you qualify for Medicaid. That in turn allows year-round enrollment.

Changed your Citizenship Status 

If you became a U.S. citizen or have been released from imprisonment, you can start over with new insurance coverage.

Encountered Exceptional Circumstances 

The Marketplace acknowledges that life events are sometimes hard to classify. If you underwent one of these types of events you may be eligible to enroll during a Special Enrollment Period. 

Changed your Household Size 

Have you recently gotten married, given birth, or had a child move out? You can enroll for new insurance coverage within 60 days of this event. 

Get Help Now!

Get in touch with us via (833) 572-0898 to get low insurance rates and other benefits, or when you need help with changing health insurance outside of open enrollment. 

References and Resources

Open Enrollment Period

Health insurance