Open Enrollment, Special Enrollment, Qualifying Event: The Basics
Many people don’t realize that there are only two primary times when you can obtain individual health insurance – during open enrollment and after a qualifying event.
Every fall, open enrollment begins. Individuals can obtain insurance through a variety of options, including their local health insurance agent.
The open enrollment period to obtain coverage for 2015 is slated to begin November 15, 2014 and end February 15, 2015. Coverage could take effect as soon as January 1, 2015. In most cases, those that don’t obtain coverage will have to pay a fine that is scheduled to steadily increase for the next few years.
The good news this year, however, is that those who had trouble enrolling by March 31st were granted extra time …
If you fall into this category, don’t delay, because the special deadline is April 15th. If you miss this one, you’re out of luck until the next open enrollment period.
That Is, Unless, You Experience a Qualifying Event
Enrollment in a health insurance plan outside of the open enrollment period may be allowed during a special enrollment period if you have a qualifying life event. Without having a qualifying event, you will not be eligible for a special enrollment period and will have to wait until the next open enrollment period (again, November 15, 2014 – February 15, 2015) to buy a new health insurance plan.
So What Is a Qualifying Event That Could “Trigger” a Special Enrollment Period?
Here are a few examples:
Change in family size: Marriage, divorce, child birth, adoption, death, etc
Job change: Loss of health coverage due to loss of job or a new job
Change in Citizenship: You become an American Citizen, or obtain national or legal status
Government error: Your coverage is changed by an error caused by the Health Insurance Exchange or the Department of Health and Human Services
New Address: You move to a new state or county, thus qualifying you for a new health plan
But keep in mind, the special enrollment period only lasts for 60 days from the date of the qualifying event.
HealthMarkets Insurance Agency is here to help you navigate a qualifying event.