Open Enrollment is your window each year to enroll in health insurance or change your plans. You definitely do not want to miss this opportunity to secure an insurance policy for the next year. However, sometimes life happens, you procrastinate a little bit too long, or you simply just forgot to enroll in a plan and now Open Enrollment has ended. The good news is you can still get coverage but your options may be limited.
The Affordable Care Act (ACA) allows for Special Enrollment Periods if you have a qualifying event. You can also enroll in short term, limited medical, gap plans, Medicaid, CHIP, and cost-sharing ministry programs anytime throughout the year if you qualify for those plans. Let's take a deeper look into these options.
Special Enrollment Periods
A Special Enrollment Period (or SEP) is a time outside of open enrollment when you are able to enroll in a health insurance plan. To be eligible to an SEP, you'll need to have a qualifying life event that meets the ACA requirements for SEPs and typically must have had previous qualifying insurance coverage (also called Minimum Essential Coverage) although some qualifying events do not require this. If you have a qualifying life event, you are typically granted a 60-day window starting from the date of the qualifying event.
You can prepare ahead of time if you know a qualifying event will be coming within the next 60 days. In most cases, you can enroll up to 60 days before the event allowing your coverage to start on the qualifying event date and avoiding any lapse in coverage.
Tip from the Pros: You will likely have to prove that you had a qualifying event when applying for an SEP. Make sure you keep any documents verifying your life event as these will have to be submitted to the Marketplace (or your state's Exchange) for verification.
Changes in my household size
You may qualify for a SEP if you or anyone in your household experiences one of the following in the past 60 days:
I'm getting married. Do my new spouse and I qualify for a SEP?
Yes. You can enroll in an insurance plan up to 60 days after the date you got married. If you choose a plan by the last day of the month, your coverage can start the first day of the following month.
I'm getting divorced or legally separated and lost my health insurance. Can I enroll in a plan?
Yes. You would have 60 days from the date of separation or a final divorce judgment is issued to enroll in a plan. IMPORTANT