How to Get Coverage After Open Enrollment

Special Enrollment Period – Qualified Coverage

If you’re like a lot of Americans, you didn’t apply for coverage in time. Now you’re trying to figure out what to do in regards to health coverage. Since the Open Enrollment Period (OEP) ended January 31, there’s really only one way to get a qualified health plan – special enrollment period (SEP). Examples of qualifying events for SEPs include:

• Moving from one state to another
• Getting married
• Having a baby
• Losing a job

This year, per the new healthcare regulations, is more strict in regards to SEP documentation. In order to enroll in qualified coverage outside of open enrollment, then proof of a qualifying event is required. For instance, if you move from Montana to Texas, then you need something in writing. Or if you’ve left your employer and have subsequently lost your coverage, then documentation either from the employer or group plan is needed.

New Job with Group Insurance – Qualified Coverage

To get a qualified health plan, you could always get a new job that offers health benefits. Though not the most practical solution, it is a viable option.

When the group set up their plan, there may be a zero waiting period. So since you are full time, then you have access to the group benefits.  Or, you have a 30 or 60-day wait period, at which point you would be added on.

Short Term Medical Insurance – Not Qualified Coverage

Outside of an SEP and group plan, there’s really no other way to get a qualified health plan. However, there are other options. Though not qualified, there is short term medical, which will provide coverage until December 31st.

Keep in mind that short term medical doesn’t provide the same coverage benefits required of an Obamacare plan. While Obamacare covers benefits like maternity, as well as preexisting conditions, short term medical does not. It’s more catastrophic type coverage.

Now if you wait until after April, you can only buy a short term plan for three months. So if you are going to get one, then you need to get one now. Having a short term plan will protect you until you can enroll in qualified coverage during the next open enrollment. Of if you have a qualifying event between now and the end of the year, then you can enroll that way as well.

Fixed Indemnity Style – Not Qualified Insurance

Another available option that is also unqualified coverage is the fixed indemnity style plan. With this plan, there’s no deductibles to meet. Everything is a first dollar benefit. So when you go to the doctor, it pay a portion of the bill. Or rather, it pays you so there’s really no maximum out-of-pocket or deductibles because again it’s not qualified coverage. As a result, this plan type, as well as a short term medical plan, subject applicants to the penalty.

In Conclusion

So much is going on right now in the media regarding the government and the healthcare law. There’s a lot of what-ifs. Regardless of what’s being said, the Affordable Care Act is still the law. We remain subject to the law so the penalty is still forcible.

With that in mind, you want to make sure your health coverage is set up correctly. Moreover, if you have a qualified health plan, continue paying your premiums. If you fail to make payments, then you will be subject to pay the penalty for the months you don’t have coverage.

Of course if you didn’t enroll during OEP and you don’t have an SEP, then you don’t have access to qualified health coverage. While you still have health plan options, they are not qualified, meaning you’re subject to the penalty. However, that doesn’t necessarily mean you have to pay it. It depends on your income and whatever the lowest cost bronze plan is.

Just know that you have options outside of Open Enrollment. And as of right now, regardless of the changes circulating in Congress, the Affordable Care Act is still the law. Therefore, healthcare will work much the same way as it has for the last four years.

Since insurance is oftentimes overwhelmingly confusing, we want to shed light on this industry by answering YOUR questions.  So if you have any questions or concerns, comment below and your question may be the topic of our next video!

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