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Missed Open Enrollment? Here's How To Get Health Insurance

Edward Neeman | Published: June 14, 2018

Darts miss board

So you missed Open Enrollment, and know you wondering you’re ever going to get health insurance. While it may seem like a big deal, there are actually millions of Americans who miss the deadline to enroll in health insurance through the Affordable Care Act (Obamacare) each year. Luckily, there is still plenty of ways for you to find cheap and comprehensive medical coverage for you and your family in 2019.

Why Open Enrollment Exists

Before we get started, it’s important to have a good understanding as to why the Open Enrollment Period exists. It may seem like a hassle, only having a short window each year to enroll in health insurance and apply for government subsidies, but it actually plays an incredibly important role in keeping the Obamacare marketplace afloat.

If Open Enrollment for health insurance didn’t exist, then individuals and families would be able to enroll in health insurance whenever they want. Doesn’t sound too terrible, right? Well, here’s the problem. When the Affordable Care Act passed, it eliminated many of the exemptions and exclusions that prevented individuals with pre-existing or chronic health conditions from getting health insurance. This forced all health insurance companies offering plans through state exchanges to accept everyone, regardless of medical history or age.

Without a shortened window to enroll in health insurance, there would be nothing stopping people from enrolling in coverage only when they need it. For example, if you’re doctor tells you that a shooting pain you have will require surgery in the near future, you can apply for health insurance to cover your operation. Scenarios like this would end up putting health insurers out of business.

What To Do If You Missed Open Enrollment?

Missing Open Enrollment for 2019 doesn’t mean you have to wait till next year, although that is an option. It simply means that you can’t enroll in health insurance plans through the marketplace, unless you qualify for a Special Enrollment Period.

However, contrary to what many may believe, the private health insurance sector is still alive and well, and may even have more affordable options for you and your family’s needs. Below we’ll discuss the various ways that you still get health insurance outside Open Enrollment.

Qualifying Life Events And Special Enrollment Periods

In some cases, you may not even have to get health insurance outside of Open Enrollment. Just like all rules, there are exceptions to the Affordable Care Act that can make you eligible for a Special Enrollment Period if you experience a qualifying life event (QLE).

The law was created with the understanding that sometimes major changes happen outside of the enrollment window, and people should not, or cannot wait to get new coverage. The Affordable Care Act outlines several qualifying life events or circumstances that would allow a person to enroll outside of the limited window.

  • Loss of previous health coverage.
  • Change in residence.
  • Change in household size such as marriage, divorce, adoption or birth of a child or death of a family member.
  • Being released from prison.
  • Becoming a US citizen.
  • Beginning or ending AmeriCorps service.
  • Losing access to Medicaid or the Children’s Health Insurance Program.
  • Becoming a member of a federally-recognized tribe.

It’s important to note that when you attempt to enroll outside of the 2019 Open Enrollment period, you will be asked for the date of your qualifying life event. All qualifying life events have a grace period from the date of the event until which you must register that lasts 60 days. If you were currently enrolled in a plan and the loss of that plan triggered your grace period, you should receive a letter from your state’s insurance program detailing the exact date of the event and the length of your grace period. You may have to provide documentation supporting the date of other life changes you report.

Filing Appeals

This option is geared towards those who were denied coverage through the marketplace, not necessarily individuals who missed Open Enrollment. If you were attempting to apply for affordable health insurance through your state’s exchange, and therefore missed the Open Enrollment Period, then you have the option to appeal the decision.

If you have proper legal grounds, then it is possible you will be granted coverage on appeal and could possibly receive retroactive coverage based on the date you would have been enrolled had your original application been granted.

The Private Sector

Contrary to what many people may believe, private health insurance plans are alive and well, including tons of options available for you outside of the health insurance marketplace. These plans include individual and family plans, short-term health insurance plans, supplemental health insurance plans, and Christian Sharing. Here’s what you can opt for instead.

When it comes to options, there is actually more to choose from in the private sector than there is in the health insurance marketplace. So, there is a good chance that you can find coverage that fits both your needs and your budget. Additionally, under President Trump, you will not face a penalty if your health insurance plan purchased outside of Open Enrollment doesn’t meet the minimum essential benefits.

There is one downside to the private sector, which is you will not be eligible for premium tax credits or subsidized coverage. That being said, if you already missed the Open Enrollment Period for 2019, then you wouldn’t be able to qualify for subsidies anyway. It’s always better to have insurance than choose to forgo it.

Wait Until Open Enrollment 2020

This is not, we repeat, not the ideal situation. Opting out of medical insurance for an entire year can leave you vulnerable to expensive bills you may not be able to pay. There are plenty of cheap and affordable options available, even outside of Open Enrollment. However, if you really want to risk it, you can choose not to enroll in medical coverage for the year.

As mentioned before, you won’t be fined for not having health insurance (unless you live in one of the following states). It’s still a gamble, but there is always next year if you decide you’d rather wait to qualify for subsidized health insurance.

Get Health Insurance Quotes Outside Open Enrollment

If you’re not sure exactly how to get started, FirstQuote Health can easily help you get health insurance outside of the Open Enrollment Period. In fact, it’s what we specialize in.

All you have to do is enter your zip code, and you’ll be able to easily shop for and compare health insurance quotes in a matter of minutes. While you may be tempted to forgo health insurance this year, it’s definitely worth taking a quick look to see what’s available in your area. You can even talk to an experienced agent for free with no obligation.