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Special Enrollment Periods

Posted by in Uncategorized on December 13, 2014

From Feb 16th through Nov 14th.

Special Enrollment

The Affordable Care Act (aka Obamacare) guarantees that almost everyone can get health insurance in the marketplace.  In most cases, you can only sign up for a health insurance plan during the open enrollment period for an on or off exchange plan.   Open Enrollment for 2015 coverage starts November 15.

If you miss open enrollment, you may be able to enroll during the special enrollment period. This runs from February 15, 2015 through November 14, 2015. To be eligible, you must have had a qualifying “life event” within the past 60 days.

What Is a Qualifying Life Event?

You have had a qualifying life event — and therefore qualify for the special enrollment period — if:

checkmarkYou move to a new area that offers you different plans, or isn’t covered by your HMO network.

checkmarkYou get married.

checkmarkYou have or adopt a child.

checkmarkYou lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.*

checkmarkYou become a U.S. citizen.

checkmarkYour income changes, or some other event changes your income or household status.

checkmarkYou can prove that your health insurance company violated its contract with you.

checkmarkYou are no longer covered on a family member’s policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.

checkmarkYou become a member of an American Indian and Alaska Native tribe.

checkmark You experience an error or other complication when trying to enroll 

How Does Special Enrollment Work?

In most cases, you have 60 days after the qualifying life event to enroll in or change your health plan. If you have insurance through your job, you may only have 30 days to enroll.   Contact Us to enroll or find out if your qualify for financial assistance through healthcare.gov.

When you sign up for or change your insurance plan during the special enrollment period, your coverage may not start right away. The date your coverage starts is based on your life event and the date you apply.

What if I Don’t Qualify for Special Enrollment?

If you miss open enrollment and don’t qualify for the special enrollment period, you can still stay insured by buying short-term insurance by contacting us.  We offer affordable short-term plans that can keep you covered until the next open enrollment period.

Please note: Short-term plans give you basic health care coverage, but they don’t meet the Affordable Care Act’s minimum essential coverage requirements. As a result, you may still have to pay a fine for having a plan that doesn’t meet these requirements.

Depending on your income, you may qualify for Medicaid or CHIP. There is no special enrollment period for those government offered coverage options – you can apply at any time.

Members of American Indian tribes can enroll any month, not just during open enrollment. You can even apply for cost assistance.