What happens if I didn’t get a health insurance plan during open enrollment but decide I want one later?

In most cases, you will not be able to get a new plan or change an existing one until the next open enrollment period. This is true for those who obtain insurance through their employers same as it is for those purchasing individual insurance plans, though the dates of these enrollment periods may differ.

However, there are some ways that you can obtain coverage even outside the open enrollment window. Certain life events could make you eligible for a special enrollment period (SEP), which allows you to change your existing plan or adopt a new one regardless of whether the normal open enrollment period is currently in effect.

The types of events that allow one to qualify for a special enrollment period fall into two main categories: specific life events and events that impact one’s eligibility for coverage. Specific life events include marriage, having a child, and the death of a spouse or dependent, and events impacting eligibility include a loss or change of job, retirement, certain changes in income, and changes in physical address/location.

It is worth noting that there are some restrictions on what you are allowed to do during your special enrollment period – in essence, you are expected to make additions and alterations that make sense in light of the event that gave you SEP eligibility in the first place. Additionally, some qualifying events will only trigger a special enrollment period if you already had health coverage but now have reason to change your plan. In situations such as this, only ACA-compliant health plans will count as existing coverage. Finally, when obtaining or changing insurance through a special enrollment period, be prepared to provide proof of the qualifying event.

Native Americans can also enroll outside of the typical open enrollment period, and provided you meet the financial requirements, enrollment for Medicaid is also open year-round.

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