Open Enrollment
If you’re going to be looking for health insurance personally (as in not provided by your employer) you want to make sure you know when you’re able to do so. With very few exceptions (which we’ll discuss in a minute) there is only one period of time when you can enroll for health insurance that you will be paying for yourself. This period of time starts at the very beginning of November and ends approximately December 15th, though it often has extensions to provide those signing up with a little extra time.
Prior to open enrollment there is a period of several months where plans are available to be viewed and evaluated before you have to worry about picking out exactly what you want and making an actual choice. Once open enrollment ends, however, you must have chosen a plan or you will be without approved and required coverage for the year. While there are some plans that can offer you minor amounts of coverage, these don’t fill the full requirements and you will be subject to fines for being without insurance unless you fit one of the special enrollment qualifications.
Special Enrollment and Who Qualifies
Special enrollment means that you have the ability to apply for and choose an insurance plan during a time that is not open for enrollment to the general public. Not everyone can get special enrollment permission as it’s something you have to apply for when you suffer from a life event that causes you to suddenly and unexpectedly be without insurance. What qualifies as a special circumstance to grant you special enrollment, however, is decided on a case-by-case basis and you are required to submit information about why you should be granted an exception to the open enrollment rule.
If you have any of the following life experiences you may (but may not) qualify for special enrollment:
· Losing coverage provided by a job
· Losing coverage provided by COBRA
· Losing health coverage from a personal plan or policy
· Losing eligibility for Medicaid, Medicare or CHIP
· Losing coverage from a family member
· You or another member of the household got married
· You or another member of the household had a baby, adopted a child or put a child in foster care
· You or another member of the household divorced or legally separated and lost coverage as a result
· A member of the household died causing loss of eligibility for the current plan
· Your household moved to a new zip code or county
· Your household moved to the United States from another country or territory
· You are a student moving to or from your school town and hometown
· You are a seasonal worker moving to or from a place you live and work
· You are moving from a shelter or some type of transitional housing
· You became a member of a federally recognized tribe
· You became a U.S. citizen and just became eligible for coverage
· You have left incarceration
· You have started or ended service with AmeriCorps VISTA
Keep in mind there are other situations that may qualify you to get a special enrollment period and these situations may not always afford you a special enrollment period. The only way you can be sure that you qualify is if you apply for one. For any of these to qualify however, you must have had health insurance for 60 days prior to applying for the special enrollment unless you are eligible to be applying for health insurance for the first time (new U.S. citizen, for example). Otherwise, you’ll have to wait until the next open enrollment.