Missed Open Enrollment? Health Insurance Options Everyone Should Know About - ELMENS (2024)

The open enrollment period for federal and private insurance plans lasts throughout late fall. Whether you missed open enrollment or you’re a new hire under a 90-day waiting period, the fact of the matter is you need health insurance.

Young adults have about a 5% chance of incurring tens of thousands of dollars in medical expenses. The odds increase as you grow older. Even during a short period, gambling on life insurance could cost you alarge fortune.

Protect your health and your wallet. Here are some health insurance alternatives if you missed open enrollment.

1. Short-Term Health Insurance

Short-term insurance companies operate in the majority of US states. They’re the perfect option when you’re between plans, waiting on open enrollment, or need proof of insurance for a quick trip abroad. That said, short-term health insurance plans are much different than those you can find through your employer or the federal marketplace.

So what are the differences? Federal and employer insurance plans require a bare minimum amount of coverage according to the Affordable Care Act. This is known as minimum essential coverage.

But short-term health insurance doesn’t have to abide by these rules. Still, these insurance plans often cover emergencies and doctor visits. They’re an invaluable buffer in case something goes wrong while you’re uninsured.

The best part about short-term health insurance is you can drop it whenever you want. You’ll also have more versatility when it comes to choosing a plan that’s right for you. Usually, employer pickings are slim.

If you’re thinking about pursuing a short-term health insurance plan, you should know that coverage, premiums, and copays can vary wildly. That’s why it’s important you compare and contrast those that fit within your budget.

Not sure where to start? Check out these plans and see how short-term health insurance differs from traditional coverage.

2. Qualifying Events

If you missed open enrollment, you aren’t completely barred from taking advantage of a new insurance plan. However, you’ll need to have something known as a qualifying event. These are special life transitions that allow you to sign up for a health insurance plan even after open enrollment.

Let’s look at some common types of qualifying events:

• Getting married or having a child

• Moving somewhere with different health coverage

• Losing your existing plan through your employer

• Becoming unemployed

• Dropping off a parent’s plan due to your age

Sometimes an explicit qualifying event doesn’t allow you to sign up for a new health plan. This typically occurs when the event doesn’t change your health insurance situation.

For example, a divorce may not be a qualifying event if you still have access to the same health insurance. This could happen if you get insurance through your own plan rather than a spouse’s.

If a qualifying event occurs, you’ll have two months to find a new health insurance plan. Missing this special enrollment period means you’ll have to wait for open enrollment to begin or go with some alternatives to health insurance.

Please note thatyou should not pursue a qualifying event just to gain health insurance coverage. Instead, pursue off-exchange health insurance until open enrollment begins.

3. Medicaid

No matter where you live in the US, you have access to Medicaid programs. These are designed to provide insurance coverage for low-income families. Medicaid is not related to Medicare in any way, and you can qualify for Medicaid even at a young age.

Medicaid does not have an open enrollment period. As long as you qualify for your state’s program, you can apply at any time. Medicaid is the best option for those who are currently unemployed and missed open enrollment in the federal marketplace.

Not sure if you qualify? Check out the official Medicaid tool.

To apply for Medicaid, you can go through either the health insurance marketplace or your state’s agency. Medicaid covers a wide array of different health expenses and usually comes without a premium. If you qualify, it’s one of the best health insurance options available.

CHIP is similar to Medicaid and covers children in low-income households. If you have a family in need of insurance, see if you qualify for either of these options.

4. Healthcare Sharing Ministries

If you have a religious affiliation, you may be able to find coverage through your place of worship. Members of the faith pay into the plan. It’s less regimented than tradition, federal, or short-term insurance as some members may directly send payments to those in need.

Just like short-term health insurance, healthcare sharing ministries don’t have to provide minimum essential coverage. They also aren’t under any legal requirement to handle medical claims for other members.

In most situations, you’ll find that healthcare sharing ministries are not the safest providers of insurance coverage. However, they are health insurance alternatives when you’re in desperate need.

Somepeople have turned to these ministries as they disagree with coverage found in traditional plans, such as contraception. Unless this is a large drawing point for you, then you probably won’t use a sharing ministry as anything more than a stopgap measure.

Health Insurance Alternatives: Which Is Right for You?

Missed Open Enrollment? Health Insurance Options Everyone Should Know About - ELMENS (2)

If you don’t qualify for Medicaid and aren’t anticipating a qualifying event, then that leaves two options of health insurance alternatives. Most people will likely lean towards short-term insurance coverage. Healthcare sharing ministries offer less legal protection, so make sure you trust your religious institution before giving it a try.

Did you enjoy this article? Then search our website for more health advice.

Missed Open Enrollment? Health Insurance Options Everyone Should Know About - ELMENS (2024)

FAQs

What happens if you do nothing during open enrollment? ›

If you miss open enrollment, you may find that you cannot enroll or make changes to your coverage until the following year. However, qualifying life events can trigger a special enrollment period that will allow for mid-year enrollments and plan changes.

What happens if you miss open enrollment for health insurance 2024 USA? ›

Marketplace Open Enrollment for health coverage in 2024 ended January 15. If you missed the Open Enrollment window, you might still have options for health coverage for the rest of the year.

What are three scenarios that qualify you for a special enrollment period? ›

You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

What is the no surprises health insurance term you should know? ›

No Surprises Act – A federal law that provides protections against getting surprise medical bills for out- of-network emergency services, some out-of-network non-emergency services related to a patient visit to an in-network facility, and out-of-network air ambulance services.

Do I need to do anything if I'm happy with my Medicare plan? ›

I want to keep my current Medicare coverage

It works the same whether you have Original Medicare (Parts A and B), a Medicare Advantage plan (Part C) or a Medicare prescription drug plan (Part D). You simply do nothing and your current coverage choices stay in place for another year.

How important is open enrollment? ›

It is an opportunity to ensure that you have the healthcare coverage you need, are prepared for the unexpected, and can take advantage of all of the benefits your employer may offer.

How long can you go without health insurance in the US? ›

If you were uninsured for a short period of time, you may qualify for an exemption from the requirement to have health coverage. What is a “Short Gap” in Coverage? A “short gap” means you were uninsured for a period of less than three consecutive months during the year.

What happens if I miss the healthcare.gov deadline? ›

What happens if you miss your deadline. If you don't meet your deadline, we'll make a new determination of the insurance and savings you're eligible for. These results will be based on information from our data sources, not what you put on your application.

What is the difference between open enrollment and annual enrollment? ›

Medicare Annual Enrollment is when anyone who has Medicare can make coverage changes for the upcoming year, while Medicare Advantage Open Enrollment is only for people who are currently enrolled in a Medicare Advantage plan.

Which of the following events might qualify you for special enrollment? ›

Get coverage when you experience a major life change.
  • You lose Medi-Cal coverage.
  • You lose your employer-sponsored coverage.
  • Your COBRA coverage is exhausted. ...
  • You are no longer eligible for student health coverage.
  • You turn 19 years old and are no longer eligible for a child-only plan.

What does CSR mean in healthcare? ›

A discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance.

What is the 5 star special enrollment period? ›

The 5-star Special Enrollment Period provides an opportunity for you to switch to a 5-star Medicare Advantage-only plan, a 5-star Medicare Advantage Plan with prescription drug coverage, or a 5-star Medicare Prescription Drug Plan.

What are the 4 most common health insurance plans? ›

Preferred provider organization (PPO) plan. Health maintenance organization (HMO) plan. Point of service (POS) plan. Exclusive provider organization (EPO)

What is the Federal No Surprise Act? ›

The NSA prohibits health care service plans, as well as providers and facilities, from surprise balance billing consumers in specified nonemergency, emergency, and air ambulance circ*mstances.

How does the No Surprises Act affect healthcare? ›

Healthcare bankruptcies increased by 84 percent from 2021 to 2022, with multiple health care organizations citing the new law along with higher costs of debt and unfavorable payer contracts as contributing factors in their bankruptcy filings.

What happens if I don't do open enrollment on Medicare? ›

Part D late enrollment penalty

You'll pay an extra 1% for each month (that's 12% a year) if you: Don't join a Medicare drug plan when you first get Medicare. Go 63 days or more without creditable drug coverage.

Do you have to do anything if you are not changing your Medicare plan? ›

In general, once you're enrolled, you don't need to take action to renew your Medicare coverage every year. This is true whether you are in Original Medicare, a Medicare Advantage plan, or a Medicare Part D prescription drug plan.

What happens if I miss open enrollment for Covered California? ›

If you miss the enroll-by date, you might have to wait until the next open enrollment period — but there are some exceptions. If you go through a major life change, you may still be able to apply for health insurance with Covered California under special enrollment.

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