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What Happens If I Missed Open Enrollment?

In case you missed the window to make health care selections for 2020, you may still qualify for a special enrollment period (SEP). Some persons in some situations may be able to buy health insurance outside of the standard enrollment period. We’re here to assist you discover if you qualify and help you if you don’t.

The Affordable Care Act (ACA) no longer needs everyone to have health coverage. You will not have to pay a tax penalty if you missed open enrollment and do not have coverage for 2020. Nevertheless, going without health insurance could leave you at risk for high unexpected medical bills. Your choices could consist of a special enrollment period, Medicaid and/or the Children’s Health Insurance Program (CHIP), short-term health insurance, and supplemental insurance.

How Do I Be Eligible for a Special Enrollment Period?

In most of the United States, to purchase private health insurance after open enrollment, you must qualify for a special enrollment period (SEP), usually lasting 60 days from the date of a qualifying life event.

Qualifying Life Events

Loss of Health Coverage

• Loss of existing health care coverage, as well as employer-provided, individually funded, and student health plans
• Losing Medicaid eligibility
• Turning 26 and losing coverage through a parent or guardian’s coverage

Changes at Home

• Getting married or divorced
• Having a baby or adopting a child
• A death in the family

Changes in Dwelling

• Moving to another ZIP code
• A learner moving to or from the place they attend school
• A seasonal employee moving to or from the place they both live and work

Special Enrollment Exceptional Situations

Some persons are in unusual and complicated situations that may qualify them for a special enrollment period. These exceptional situations include events that may have prevented enrollment in a health care plan, including:

• Abrupt hospitalization or temporary cognitive disability
• Natural disasters, such as wildfires, earthquakes, and hurricanes
• Domestic abuse or spousal neglect
• Technical or human errors during enrollment that were not your mistake

Medicaid and the Children’s Health Insurance Program

In all states, Medicaid offers coverage for low-income people, families, kids, pregnant women, the elderly, and people with disabilities. Similarly, CHIP provides low-cost health coverage to kids in families that earn too much to be eligible for Medicaid. CHIP also covers pregnant women in some states, and some states have expanded their Medicaid programs to cover anybody who falls below certain income levels.

If your state has expanded Medicaid, income is the only prerequisite. In states without expanded Medicaid, qualifications differ and may consider income, household size, disability, age, and more. Qualifications for CHIP differ from state to state. To find out if you are eligible and apply for Medicaid or CHIP, go to the Health Insurance Marketplace or the Medicaid agency of your state.

Short-term health insurance is temporary health insurance that can aid fill in the gaps in health care coverage. Also, it can be a solution if you’re between jobs, have begun a new job, and are waiting for new coverage to start, are waiting to become eligible for Medicare, or don’t have health insurance because you missed open enrollment. It’s not right for everyone, nevertheless, and benefits can be quite limited.

Resources and References:

• Qualifying Life Events
• Benefits of CHIP