Special Enrollment Periods
Insurance enrollment for 2015 ended February 15, 2015. After February 15, you will be outside the open enrollment period. The next open enrollment period for 2016 coverage will start November 1, 2015 and end January 31, 2016.
Know Your Options Outside Open Enrollment
Special Enrollment Periods Following a Qualifying Event
Most Americans are required to have ACA-approved health insurance coverage or face a tax penalty. If you don’t have health insurance coverage through your employer, you can purchase a plan during the ACA open enrollment period that occurs around the end of the year. But what happens when you are outside of that period?
Outside of an open enrollment period you have few options to get health coverage – unless you experience a qualifying event that entitles you to a special enrollment period.
A qualifying event is a defined event or “triggering event” that results in an individual being given a specific time period to enroll for health insurance. A special enrollment period is a time period that is triggered by a defined event or “qualifying event” that allows an individual to enroll for health insurance.
The following is a list of the most common qualifying events:
- Marriage or divorce
- Addition of a dependent (including birth of a child, adoption, or having a child placed in your custody)
- Loss of health coverage (such as losing insurance due to loss of a job or becoming ineligible for Medicaid)
- Permanent move to an area with different qualifying health plans
- Newly gained American citizenship
- Becoming newly eligible or ineligible for advance premium tax credits or cost-sharing
- Misconduct by an exchange or marketplace navigator, agent/broker, insurance representative, or health plan during enrollment
- Errors or contract violations that occur and are noted by the insurance exchange or state marketplace
If you voluntarily drop your insurance plan or do not pay your premiums, this does not allow you to qualify for a special enrollment period. You will have to wait until the next enrollment period to choose a new plan or consider alternative health care options such as a short-term health plan.
Contact an HSA for America Personal Advisor at 866-749-2039 to see if you qualify for a special enrollment period and to apply for coverage, including premium assistance if you qualify.
Special Enrollment Periods for Individuals and Families With Policies Terminating on Their 2014 Anniversary Date
In 2013, many policyholders had their insurance plans cancelled because they were not ACA-compliant. Following the cancellation of millions of policies, the Obama administration announced in late 2013 that they would allow policyholders to keep their insurance policies for one additional year.
Some carriers continued with cancellations while others extended policies for an additional year. Many of these policies were set to terminate on their anniversary date in 2014.
In March 2014, the Obama administration again made changes to the Affordable Care Act, allowing policyholders to keep their plans for an additional two years – or until 2016.
Carriers have to make the tough decision again of whether to follow through with policy cancellations and move on to ACA-compliant plans, or allow their customers to continue with their current plans for another two years.
As we receive information from carriers stating their decision to cancel or renew policies, we will begin posting this information on our website as quickly as possible.
If your policy is terminating (or being cancelled) upon its anniversary date in 2014, this allows you to qualify for a special enrollment period to purchase another health plan on or off the exchange per guidelines set by the Affordable Care Act.
You will also be entitled to apply for premium assistance if you qualify. If you’re unable to find an “affordable plan,” you may qualify for an exemption to the tax penalty. You also have the option of choosing a short-term plan to fill in the gap until the next open enrollment period.
Contact an HSA for America Personal Benefits Consultant at 866-749-2039 to apply for coverage, including premium assistance, if you qualify
How Do Special Enrollment Periods Work?
Following a qualifying event, you typically have 60 days from the date of the event to seek new health insurance coverage. A qualifying event such as getting married, losing a job, or having a baby could also change your eligibility for premium assistance.
If you’ve been notified in advance that you will be losing your health insurance coverage, some special enrollment periods begin 30 days prior to the termination date of your plan and last for 30 days after your plan terminates. Your Personal Benefits Consultant can help you determine exactly when your special enrollment period begins and ends.
HSA for America Personal Benefits Consultants are available to assist you with finding a health plan in your area and can help you apply for a premium subsidy if you qualify. ACA-approved plans are guarantee-issue, so you can’t be denied coverage due to a pre-existing illness.
Contact an HSA for America Personal Benefits Consultant at 866-749-2039 to see if you qualify for a special enrollment period and to apply for coverage, including premium assistance if you qualify.
Getting a Health Plan When You Don’t Qualify for a Special Enrollment Period
Maybe you were unable to pay your premiums, or maybe you just weren’t able to get coverage before the open enrollment deadline – how do you get covered now? There are few options at this point, but your best option is likely a short-term health plan.
Short-term plans are less expensive than traditional plans, and you can be covered as soon as 24 hours from the time you apply. Click the link below to run an instant quote and apply online:
At HSA for America, we also offer additional money-saving tools to save on health care expenses including prescription drug discounts, lab and imaging discounts, and bill negotiation services. Another alternative is supplemental accident insurance coverage. All of these services can be quite helpful, especially if you’re currently uninsured.