Can you get health insurance now? It depends on the time of year and your individual circumstances.
We’ll cover two scenarios (shown in the table below) and you’ll need to take action depending on what time of year it is when you’re reading this blog post.
|What Month is it?
|Is it the Annual Open Enrollment Period?
|Can You Get Major Medical Health Insurance Now?
|Can You Get Temporary Health Insurance Now?
|Nov. to Dec.
|Yes (most states)
|If you qualify*
If your state allows**
|Jan. to Oct.
|No (most states)
|If you qualify for special enrollment
|If you qualify*
*You must be approved by the carrier in order to enroll in a short term health insurance plan.
**Some states do not allow the sale of short term policies during annual open enrollment.
Nov to Dec: Enroll During the Annual Open Enrollment Period
The annual open enrollment period is the easiest time of the year to enroll in Affordable Care Act (ACA)-qualifying major medical health insurance, particularly if you do not get benefits through an employer or parent and need to buy your own coverage.
So, when is the annual open enrollment period?
Since the beginning of the ACA (also known as “Obamacare”) annual open enrollment dates and durations have varied somewhat year to year.
For example, the second annual ACA open enrollment period lasted a full three months, from November 15, 2014 to February 15, 2015. By contrast, the most recent open enrollment period, for plans beginning January 1, 2019, lasted only 6 weeks, from November 1, 2018 to December 15, 2018.
Regardless of the duration, open enrollment has always begun during the first two weeks of November. So at the very least, you can add a “health insurance open enrollment” reminder to your calendar for November 1 right now.
To add a little more confusion to the mix, some states operate their own ACA exchanges and have different open enrollment durations that may extend beyond the federal ACA enrollment period, so be sure to validate the open enrollment period in your state.
Why Major Medical Insurance?
Major medical insurance is ACA-qualifying coverage. That means that the policy meets the requirements of the ACA, such as providing coverage for essential health benefits and being guaranteed issue (covering pre-existing conditions and at no additional cost).
In the universe of health insurance, major medical insurance represents the highest level of coverage you can obtain. Because these plans cover so many medical services and most of us can’t predict when, if or how severely we may become sick or injured, major medical tends to be a good option, coverage-wise, for a lot of people.
The other benefit of ACA-qualifying plans is that when you enroll in a plan from the federal (or state) marketplace, you can qualify for a subsidy or premium tax credit if your household income level meets the requirements. If you qualify, this may help you gain access to coverage that you may not have otherwise been able to afford on your own.
Find out if you qualify for a subsidy.
Is major medical insurance the only kind of coverage you can enroll in during open enrollment?
There are other types of coverage that do not meet the ACA’s standards and these plans can be applied for year-round.
Short term medical insurance is an example of non ACA-qualifying health insurance that typically has lower monthly premiums and less coverage than major medical plans. In addition, they’re not guaranteed-issue, so you must complete a health questionnaire and be approved by the carrier in order to enroll in coverage (pre-existing conditions may disqualify you).
We’ll talk more about these non-Obamacare insurance plans below…
Jan to Oct: Special Enrollment Period, Other Minimum Essential Coverage or Alternative Coverage
If it is not the annual open enrollment window, how do you get health insurance? Here are your options:
- If you qualify for a special enrollment period you can enroll in major medical coverage.
- If you do not qualify for special enrollment, see if you qualify for another form of minimum essential coverage.
- Apply for non-ACA coverage like short term health insurance.
Let’s take them one at a time…
Qualify for a Special Enrollment Period
Certain life events qualify you for a special enrollment period for major medical insurance. This is a 60-day period from the date of the qualifying event. Some qualifying events include losing your job (and your job-based coverage), getting married or divorced, and permanently moving to a new zip code where your existing coverage is not available.
Remember, there’s a clock ticking on your special enrollment period so if you think you may qualify, you should take action now to get health insurance.
Other Minimum Essential Coverage
Other federal and public programs provide ACA-qualifying minimum essential coverage and could be a way for you to get health insurance now if you qualify. These programs include:
- Medicare – During your 7-month initial enrollment period or the Medicare general enrollment period (Jan. 1 – Mar. 31). Learn more about Medicare enrollment.
- Medicaid and CHIP – Apply, enroll and start coverage anytime during the year if you qualify.
What if you don’t qualify for a special enrollment period or any other minimum essential coverage? Can you still get health insurance?
But it’s not major medical insurance.
Short Term Health Insurance
Short term health insurance is an alternative to going uninsured while you’re between major medical plans and outside of the annual open enrollment period.
This type of coverage is much more limited than major medical, so it’s really important to closely review any short term policies you’re considering so you know what is and is not covered.
Short term health insurance does not provide the same level of coverage as ACA-qualifying major medical plans. For example, most short term policies do not cover pre-existing conditions or preventive care, so you won’t be able to use your short term plan at your annual doctor’s office visit or when getting a prescription filled.
The purpose of a short term policy is to help you afford a trip to the emergency room or hospitalization resulting from an unexpected illness or injury.
The monthly premiums for short term medical plans are comparatively lower than major medical plans because the policies cover less and exclude more.
In addition to the lower premiums, if you qualify and are approved for coverage, you can begin coverage as soon as the next day (there’s no waiting period).
Learn more about the pros and cons of short term health insurance.
The only way to find out if short term insurance is available in your area and how much it will cost is to get a quote.
(It just takes a minute to see and compare multiple policies).
Summary + Next Steps
Whether or not you can get health insurance now depends on:
- If it is during the annual open enrollment period;
- Your life circumstance (i.e., do you qualify for a special enrollment period or another form of ACA-qualifying public insurance) and;
- What your health insurance coverage needs are – for example if you prefer a more limited but lower premium coverage option for a shorter duration while temporarily between jobs, you can apply for short term medical insurance any day of the year and obtain coverage after being approved by the carrier.
If you have questions or want to get professional assistance, call [phone_number] to speak with a licensed insurance agent.