What to Do If You Missed Open Enrollment

Open Enrollment is the annual period when anyone can enroll in health insurance for the following year. It ends every year on December 15th.

If you missed it, don’t think that you’re out-of-luck when it comes to health insurance coverage next year. You may still have time to enroll in a health plan for the coming year, even if it’s not a qualified health plan.

Here are five things you should do to see if you can still get coverage:

  • Check the Open Enrollment dates in your state
  • See if you qualify for a Special Enrollment period
  • Review eligibility for government-sponsored health plans
  • Find a job with health insurance benefits
  • Consider other options

Check the Open Enrollment dates in your state

While most states end Open Enrollment on December 15th, some have extended it.

For example, California, Colorado, and Washington, D.C. have permanently extended their open enrollment periods. California and Washington, D.C.’s open enrollment periods end on January 31st. Colorado’s open enrollment period ends January 15th.

If you enroll after December 15th, your Affordable Care Act (ACA) coverage may start February 1st instead of January 1st.

Other states may choose to extend the enrollment period on an annual basis. However, states that have lengthened the period in the past may not lengthen it in the current year.

A quick Google search can help you find out what your state is doing. You may still have time to enroll in a health plan for 2022.

See if you qualify for a Special Enrollment period

Whether or not your state has extended open enrollment, you may qualify for a special enrollment period if you experience a qualifying life event, like getting married or divorced, having or adopting a child, or moving to a new state.

Missing open enrollment alone doesn’t usually qualify you for a special enrollment period.

Review eligibility for government-sponsored health plans

Government-sponsored health plans like Medicaid and CHIP typically allow enrollment throughout the year. Medicaid and CHIP are available in all 50 states, U.S. territories, and Washington, D.C.

Medicaid and CHIP eligibility is based on your income level. Eligible income levels vary by state. The Medicaid website for your state can give you more information on eligibility requirements and enrollment.

Find a job with health insurance benefits

If your current employer does not offer health insurance in its benefits package or if you can’t afford what your current employer offers, you can start applying for other jobs with employers that do offer an affordable benefits package.

Keep in mind that it’s best not to ask for details about the benefits package until you have an offer. If you ask for details about the benefits package before, it can show the company that you’re more interested in what they can do for you than what you can bring to their company. The company may not be convinced of the value you bring and decide not to make an offer.

Once you have an offer, asking questions about the benefits package is totally appropriate.

Some jobs have a waiting period for benefits to start. Keep this in mind as you consider job offers. Look into other health insurance options, like government-sponsored plans and short-term health insurance, to give you some coverage while you wait for full benefits.

Consider other options

If you are unable to enroll in an Affordable Care Act (ACA) plan, you can consider other ways to manage your health expenses, like short-term health insurance and prescription discount finder tools.

Short-term health insurance

“The ACA is the only health insurance coverage that limits consumers to buying within the open enrollment period, and there are several options available throughout the year,” says Jan Dubauskas, Vice President at Health Insurance Innovations, Inc. (HIIQ).

Short-term health plans don’t cover everything a qualified health plan does, like pre-existing conditions, but they can help cover preventive care and emergency care. Some plans include coverage for prescriptions. Carefully review what each short-term health plan covers because there is variability.

Be aware that you and anyone else on the health plan will need to go through the underwriting process to be accepted on the plan at specific rates.

When the Affordable Care Act first became law, it included a tax penalty for not having qualified health coverage.

“Starting in 2019, there is no longer a penalty for choosing to forego an ACA plan, which means that if someone doesn’t need the robust coverage available under the ACA, they can buy another, more affordable type of health insurance like short-term medical without risking a tax penalty,” says Dubauskas.

While there is no longer a federal penalty, you may be subject to tax penalties at the state level depending on your state’s laws.

States also have different guidelines regarding short-term health insurance.

“Short term medical is now available in many states for up to 36 months,” says Dubauskas.

While short term health insurance may be available for long periods of time in many parts of the United States, some states may have different rules.

Double-check the guidelines in your state and keep them in mind as you navigate purchasing health insurance.

Prescription pricing tools

Prescription pricing tools are becoming increasingly common. While these pricing tools aren’t considered insurance, they can help you manage your medication costs.

One example is RxSaver by RetailMeNot.

“RxSaver is a website and an app that shows you the lowest retail prices at pharmacies in your neighborhood. You just put in your drug name and choose from a list of prices at nearby pharmacies,” says Dr. Holly Phillips, Board Certified General Internist in Manhattan and a Medical Expert for RxSaver by RetailMeNot.

Knowing your options can help you ensure that you have the health coverage you need to maintain your physical, mental, and financial health.

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