With the Affordable Care Act, also known as Obamacare, many individuals were introduced to the idea that they now have the choice of purchasing their personal or family healthcare plans outside of the standard group plan offered by their employer.
Because the details of this type of purchase are a bit different than usual, seeking out the help of an insurance broker is a wise choice. Insurance brokers hear most of the same questions from day to day, the most significant one being where can I get a plan to cover myself or my family?
Another question includes is there a specific timeframe for deciding on and purchasing a plan? We must first look at open and special enrollment and how each works within the healthcare insurance system to sufficiently answer this question.
Can Health Insurance Be Bought At Any Time?
The first point to understand is that insurance providers have established a timeframe in which individuals are permitted to purchase health insurance that is considered Obamacare compliant for themselves or their family members. The time frame is referred to as the open enrollment period.
During the designated open enrollment period, everyone has the opportunity to either purchase or change any health insurance plan that is purchased on the exchange. The open enrollment period, or OEP, is a once-a-year event, running most often 24 hours a day, seven days a week, beginning on November 1and ending on December 15th.w
The OEP gives the individual the ability to search for a qualified health plan (QHP) without any complications. The individual will need to take stock of their individual or their family's healthcare needs and apply for the coverage before the enrollment period ends. However, there are instances where individuals can purchase plans outside of the OEP, including if they fall under the eligibility due to a qualifying life event.
Purchasing A Plan Outside The OEP
Consumers need to understand that unless particular circumstances apply when the OEP timeframe has closed, they may be required to wait another year to obtain insurance through the exchange. The only way to purchase compliant health careplans after the OEP on the exchange is if the individual meets the specific criteria laid down for special enrollment.
As defined on the federal marketplace exchange, Healthcare.gov, the special enrollment period is defined as that time outside of the open enrollment period wherein those individuals who meet the required criteria can purchase either an individual or family policy.
Due to a specific life event, those individuals considered qualified may be eligible for the special enrollment. Such events include:
- Recently married
- Recently divorced
- The recent birth of a child
- Death of a current policy member
Changing your residence may also qualify as a special life event, such as:
- Moving your primary residence to a different zipcode and/or county
- Moving into the US
- Students transferring to and from school
- Seasonal workers
- Transitional situations such as moving from ashelter into an apartment
If you lose your current healthcare plan, you will also qualify for special enrollment in cases such as:
- Your job-based coverage ended
- Loss of an individual or family plan through no fault of your own.
- The loss of government healthcare assistance such as CHP, Medicare, or Medicaid.
- Loss of coverage provided through a familymember.
At the current time, once you are eligible for a qualifying life event, you will have a period of 60 days to find and apply for one of the qualified health insurance plans on the exchange.
If you are unsure if you qualify for the criteria allowing you special enrollment, reach out to a professional insurance broker for assistance. Through consultation, they will help you determine if you are eligible and guide you in finding a compliant plan that you are eligible to sign up for.
Here at Savvi, our mission is to help people take the stress out of buying health insurance in Houston, San Antonio, Dallas, Ann Arbor, and Grand Rapids. Feel confident by knowing that you'll have the absolute best plan that fits your lifestyle & budget. We look forward to working with you.