HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES
Experiencing a qualifying life event allows you to apply for Affordable Care Act (ACA) health insurance coverage outside of the annual ACA open enrollment period.
The ACA created a nationwide open enrollment period for on-marketplace plans (carriers are permitted to have different open enrollment periods for off-marketplace plans but with few exceptions most carriers follow the on-marketplace rules). For 2019 it runs from November 1, 2018 through December 15, 2018 for a January 1, 2019 effective date.
During open enrollment anyone can purchase individual and family health insurance on their own.
However, if you experience a major life changing event (termed a "qualifying life event" under the law) you may be eligible to purchase a personal Obamacare plan outside of the ACA's open enrollment period.
OPEN ENROLLMENT CALENDAR
What Are Some Qualifying Life Events?
Qualifying life events that may trigger a special enrollment period for yourself and your family outside of the ACA's open enrollment period include the following:
- Marriage or divorce
- The birth or adoption of a child
- The loss of employer-based health insurance coverage
- Moving to a new city outside your old plan’s coverage area
- Changes in income (generally at least 20%) that affect your eligiblity for a subsidy
- Loss of Medicaid
Be aware that in most cases you will need to provide documentation showing that you experienced one of these (or other) qualifying life events and that you generally will have to show that you had continuous coverage (i.e. you were covered by some other plan for at least one day in the sixty days prior to the event).
How Long Will I Have To Enroll In A New Plan?
If you experience a qualifying life event, in most cases you will have a sixty-day window during which you can enroll in a new ACA health insurance plan and apply for an ACA subsidy if you meet the income criteria.
Missed the Affordable Care Act Open Enrollment Deadline?
- Determine if you have a qualifying life event that permits you to enroll in an ACA plan. Note that regulations were finalized and issued on June 19, 2017 that require (1) proof of occurrence and (2) also in most cases proof that you were covered by an ACA plan within 60 days of the event's occurrence
See of you qualify for a subsidy and receive an estimate of the amount
Enter the required information (as well as the optional information to receive a subsidy determination) and submit the quote request form. We'll contact you to review premiums (less any subsidy), available plans, whether your doctor accepts the plan, and how your medications are covered.
Click here for more information about Short-Term Health Insurance. A Short-Term Health Insurance policy can tide you over until the next January 1 ACA plan effective date (no qualifying life event is required during Open Enrollment). Short-Term Health Insurance plans can also be purchased with supplemental or gap plans like hospital indemnity, accident, critical illness, cancer and other plans that may lessen your exposure to large medical expenses.
Note: please contact us at 877-734-3884 to determine if you may qualify for other types of programs (e.g. medical cost sharing or tribal health cooperatives) that could work for your particular situation. Depending on the program, these programs are either ACA-qualified or are exempt from ACA requirements. In either event, there is no tax penalty for participating in these programs (the tax penalty will be removed effective January 1, 2019.) These programs operate differently than traditional insurance; some or all of the elements of these programs are NOT insurance and not regulated by state departments of insurance or consumer affairs.
Frequently Asked QuestionsThe Affordable Care Act is complicated and can be quite confusing. Find answers to many of the most frequently asked questions regarding provisions of the law that affect individual and family health insurance. LEARN MORE.
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