A lot has been made of the changes that the Affordable Care Act (ACA) brought to health insurance. One of the big focuses has been the specific open enrollment periods. With the ACA, you cannot purchase individual insurance anytime you would like. Instead, you have to purchase within a specific window of time each year.
What many Americans don’t know is that there are exceptions to that rule. If you experience a qualifying life event, you have a special enrollment period available to you where you can change or purchase new insurance.
Understanding Special Enrollment Periods
- Losing other health coverage, such a job-based coverage.
- Moving to a new state.
- A significant change in income (including losing a job).
- Changes in family size. This includes marriage, divorce, having a child, or adopting a child.
Moving to a new state puts you in an entirely different insurance Marketplace, so you are given a chance to purchase new coverage in your new home state. Income changes can cause changes in tax subsidies, and losing or leaving a job that offered insurance also permits you time to buy new coverage. And changes in family size require you to have a period of time to add or remove family members from coverage.
Why Special Enrollment Periods are Important
If you don’t realize that you’ve had an event that allows you to update or enroll in new insurance, you’ll often miss your opportunity. Special enrollment periods are only 60 days long, and many start the day of the qualifying event. Time moves quickly, and 60 days could pass without you making needed changes to coverage.
In addition, millions of Americans are still without health insurance. Many of them do not realize that they have life events during a year that would make them eligible to purchase insurance. This causes them to continue without insurance, even though they’ve had a significant change that might qualify them for tax subsidies, Medicaid, or the Children’s Health Insurance Program (CHIP).
Unfortunately, this means that millions of Americans will continue to be uninsured needlessly, because they aren’t aware of the opportunity to add coverage for themselves and their families. This could lead to significant financial hardships or the skipping of important physical exams to detect illness, causing even more problems for the family.
Being aware that insurance is available throughout the year in certain cases is important. If you are currently uninsured, be aware that changes in income or family size could give you a new opportunity to apply for coverage, often with additional financial assistance available. If you do have coverage and experience a life change, be sure to make needed changes before your 60 day special enrollment period expires.
For more information on making changes to your health insurance plans after the Open Enrollment window, read How to Change or Cancel Your Health Plan After Enrolling.