Along with many other sweeping changes ushered in by the Affordable Care Act, periods that limit the time for individual health plan enrollments came to be. Originally running from October to March, open enrollment periods have been gradually condensed to November through January, and there is talk of making the period for 2018 even briefer.
While this may be frustrating for many Americans—being forced to enroll in health plans during a certain time of year—it’s necessary to protect individual insurers from too much risk. Along with the enrollment period changes, the Affordable Care Act ensures that individuals with pre-existing conditions cannot be turned down for health insurance. But this means that many new and expensive-to-insure people were suddenly eligible to enroll in coverage. To prevent individuals waiting to enroll in insurance only after they need to use it (for a broken arm, after a cancer diagnosis, etc.), open enrollment periods were created.
But what does that mean for me?
If you followed the open enrollment guidelines and already enrolled in your 2017 health insurance, you should be set for the year as long as you keep up with your premium payments. But if you missed open enrollment, you may be wondering if you can still enroll in Affordable Care Act coverage. The answer may be yes. Some individuals and families qualify to enroll outside of open enrollment.
Outside of Open Enrollment, there are what are known as special enrollment periods. These are brought on by qualifying life events—major life changes that necessitate “off schedule” insurance changes. The most common kinds of qualifying life events are:
- Losing your job
- Adding a child to your family
- Ageing off of parental coverage
- Moving to a new plan service area
There is a variety of ways to qualify for special enrollment periods—many more than just those listed above.
So can I enroll?
With so many different rules and regulations around open enrollment periods, qualifying life events and special enrollment periods, it’s difficult to know if you’re eligible to apply for coverage. But don’t worry! Let a licensed agent help you determine if you qualify, and—even more importantly—which plan is right for you.
Have you experienced one of these life changes?
|Marriage||Certificate of marriage or domestic partnership||No later than 60 days after marriage|
|Divorce||Divorce decree or custody agreement||No later than 60 days after coverage end date. In custody agreement, coverage may backdate to date court ruling finalized.|
|Birth or adoption||Birth certificate or adoption paperwork||As soon as 60 days before adoption, but no later than 60 days after birth/adoption|
|Loss of dependent status (ageing off or primary policyholder death)||Coverage termination letter from carrier or death certificate||As soon as 60 days before, but no later than 60 days after coverage end date|
|Job loss||Letter stating coverage is being terminated due to job loss||As soon as 60 days before, but no later than 60 days after coverage loss|
|Loss of eligibility for Medicaid||Letter from Medicaid office||No later than 60 days after coverage end date|
|Moving out of plan service area||Coverage termination letter from carrier AND a utility bill at new address or new lease agreement.||As soon as 60 days before, but no later than 60 days after move.|
|Return from Armed Forces active duty||Military documentation||No later than 60 days after return|