Missed the enrollment deadline? Here’s how to get health insurance after open enrollment
The open enrollment period for a Marketplace plan runs annually from the beginning of November to the middle of December. During this time, Americans are able to register for a health insurance plan and start enjoying the benefits of that plan beginning January 1st. If you do not enroll during this time period, with few exceptions, you are not eligible to enroll throughout the rest of the year, so you are well advised to plan ahead and enroll in an insurance plan during that time if you anticipate needing insurance during the year.
If, however, you have missed the open enrollment period but still need health insurance, there are two exceptions that you may qualify for, that will allow you to enroll after the period. Those exceptions are:
- If you qualify for a Special Enrollment Period
- If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP)
Special Enrollment Period
If you missed the open enrollment period, you may qualify to enroll anyway, if you meet the criteria for a special enrollment period. To qualify for this period, you need to have a qualifying life event. Qualifying life events include:
- Losing your job and employer-provided health insurance
- Getting married
- Having a baby or adopting a child
- Getting divorced or separated and losing you insurance
- The death of your previous insurance plan holder leaving you without insurance
- Turning 26 or otherwise losing your parent’s health insurance
- Losing eligibility for Medicare or Medicaid
- Moving to a different zip code
- Becoming a U.S. citizen
- Leaving incarceration
If any of these qualifying events are met, you will most likely be eligible for a special enrollment period. To see if you qualify for a special enrollment period, and to enroll in a health insurance plan if you do meet the qualifications, you can visit https://www.healthcare.gov/screener/.
Qualifying for Medicaid or the Children’s Health Insurance Program (CHIP)
Medicaid and CHIP are government programs that aim to provide low-cost health insurance to the most vulnerable in society, or to people who are in need temporarily due to unforeseen circumstances. Millions of people get their health insurance through Medicaid and CHIP. The primary members of these programs include: people with low incomes, families with children, the disabled, the elderly, and pregnant women. Families with children who earn too much money to qualify for medicare may qualify for CHIP (in fact, CHIP was established in order to address this exact problem) so even if you have been denied coverage for Medicaid, CHIP may be a good option for you.
To see if you qualify for CHIP of Medicaid, you can fill out an application through the Health Insurance Marketplace. If you or anyone in your family qualifies for CHIP or Medicaid, your state agency will contact you and provide the details and next steps for enrollment. There is no deadline or cutoff period for applying for CHIP of Medicaid, so if you feel you may qualify, you can submit an application at any time of the year.
Typically, CHIP and Medicaid plans provide good coverage for people in need. The benefits vary state by state, but in general, the plans usually cover:
- Checkups and physicals
- Doctor visits
- Prescription drugs
- Immunizations and vaccinations
- Dental care
- Hospital care
- X-rays and lab work
Conclusion: How to Get Health Insurance After Open Enrollment
If you need health insurance but have missed the open enrollment period, you may be concerned that you will be unable to find coverage. However, there are many options available, and most people who suddenly find themselves without insurance or unable to afford their existing insurance, do qualify for a special enrollment period or for CHIP of Medicaid.
So, if you have found yourself without coverage or expect you might find yourself without coverage soon, and don’t have time to wait for the open enrollment period, there is a high likelihood that you will be eligible to get coverage either through the health insurance Marketplace or through a government program to provide low cost health insurance.
If you find yourself in this situation, do not delay. Check your eligibility immediately, as there can be 60-day periods that you remain eligible for a special enrollment period (for example, within 60 days of getting married or within 60 days of losing you job).