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Health Insurance Special Election Periods For Open Enrollment

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Special Election PeriodsHealth insurance open enrollment under Obamacare has different rules. Unless it’s Open Enrollment, you may not be able to purchase health insurance without a qualifying event.

Special election periods will be available outside of open enrollment for those who meet certain criteria. If none of the life events listed below apply, then applicants will need to wait until the next open enrollment window in the fall – or purchase a short term or limited benefit plan – in order to have some coverage.

While short term and limited benefit insurance plans will not avoid Obamacare penalties, they will offer some protection against unforeseen medical bills. In other words, they can help bridge the gap.

Obamacare Special Election Periods & Qualifying Events

There are several qualifying events that will open up a special election period for those who want/need to purchase health insurance outside of the Obamacare open enrollment window that closed on March 31st, 2014. These events will allow for the guaranteed issue of an insurance plan either on or off of the exchange.

If you qualify for a subsidized plan, then you will need to purchase coverage on the Federal Health Insurance Marketplance either with or without the assistance of an insurance agent. If you do not qualify for a tax credit, then it may be best to purchase a plan off of the exchange with an insurance agent.

The Special Election Periods are as follows:

  • Losing your health coverage through a life event
  • Examples of these life events include: getting a divorce, losing your job, losing your Medicaid or CHIP eligibility, your current plan being decertified or expiring COBRA coverage… basically any time someone loses their coverage through no fault of their own
  • Individuals receiving their renewal notice from their carrier enhancing their benefits. If they decide not to take the new offer, this is a life event
  • Please note: If you voluntarily quit your health plan or are terminated because you didn’t pay your premiums, you are not eligible for a special enrollment period
  • Having or adopting a child, or placing a child for adoption
  • Permanently moving somewhere with different health insurance options
  • Experiencing an enrollment error
  • Having a change in income or household status that changes your eligibility for tax credits or cost-sharing reductions
  • Your plan or issuer substantially violating a material provision of the contract you’re enrolled under
  • Individuals losing their coverage through work when their employers decide to drop health insurance from their benefits packages at renewals starting 4/1/14 and beyond

As you can see, there are several events that will trigger a special election period for the purchase of health insurance either on or off the exchange. The most common event will simply be the involuntary loss of coverage.

In this way, health insurance will now work somewhat like Medicare supplement insurance. When someone over 65 involuntarily loses group health insurance, they can automatically purchase a Medicare supplement plan no questions asked.

What If I Don’t Qualify For A Special Election Period?

If you don’t qualify, then you have two options: You can either wait for the next open enrollment period or purchase a short term or limited benefit plan.

While short term health insurance plans and limited benefit policies will not provide full coverage (and won’t eliminate Obamacare penalties) they will bridge the gap until the next open enrollment window. We can help you shop for both types of plans so that you have some coverage.

Contact Us For Health Insurance Quotes & Information

Without a Special Election Period, you cannot purchase traditional health insurance either on or off the exchange until the next open enrollment window.

Our independent health insurance agency offers short term and limited benefit plans to help individuals and families obtain some coverage until the next open enrollment window.

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Category: Health Care Reform, Health Insurance