How to Get Health Insurance Coverage After Open Enrollment

Friday, March 6, 2015
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ObamaCare restricts the purchase of most health insurance plans to a three-month enrollment period each year. Circumstances, however, may require you to purchase insurance outside this window. Although you may find options a bit limited, you can get health coverage after open enrollment using the following methods.

Special Enrollment Period

ObamaCare offers qualified individuals a chance to get a comprehensive health plan outside the normal enrollment period.

You may qualify for such an enrollment due to an eligible life change. Birth and adoption allow the purchase of insurance for new family members. Involuntary changes in coverage status, resulting from events like divorce or relocation to a new area, may extend enrollment to affected individuals. Because eligibility can hinge on occurrences obscure as gaining membership in a Native American tribe, you should consult a licensed insurance professional to see if you qualify.

Complications with an earlier application may also qualify you for special enrollment. If an extraordinary event, such as a hospitalization or natural disaster prevented you from applying during normal enrollment, you may be eligible for a special one. Fraud or error related to an earlier application may result in another chance to apply. Other circumstances, from improper Medicaid referral to domestic abuse, may also qualify you.

If all else fails, you can appeal to both federal and state Marketplaces. An appeal can be be a lengthy process, but you can request to have it expedited.

Temporary Health Plans

Temporary health plans provide coverage for a fixed duration, and can bridge the gap between enrollments. Temporary plans mostly differ from traditional ones in that they are not guaranteed renewable. Because eligibility may change by the time the policy renews, these plans seldom make a reliable means of continuous coverage.

Since the ACA does not address temporary plans, they retain features predating healthcare reform. These plans typically have lifetime maximums, waiting periods and minimal preventive benefits. More importantly, insurers offering these plans can reject applicants on the basis of preexisting conditions and even rescind policies for nondisclosure of conditions.

Despite their shortcomings, temporary health plans may offer the most comprehensive coverage outside open enrollment, short a special one.

Limited Benefit Plans

In a pinch, limited benefit plans can provide basic coverage. Mini-med, indemnity and hospital/surgical policies have, in addition to the shortcomings of temporary plans, relatively low benefits unrelated to actual charges for treatment. Benefit limitations come in the form of annual maximums, daily allowances and per-service fees, which can leave you with considerable liability.

Even with their shortcomings, limited policies may prove better than going uninsured. Unlike temporary plans, many limited ones offer guaranteed renewal. A licensed agent or broker can help you select a limited plan from a field where pitfalls abound.

Supplemental Plans

Supplemental plans offer benefits for specific injuries and illnesses. Accident, cancer and heart attack/stroke policies cover some of the most common medical claims. In addition, critical illness policies can cover a relatively large range of conditions, from cancer to renal failure.

Supplemental policies typically come in two varieties: lump sum and limited benefit. Lump sum policies make a single, large payment to the insured, usually upon diagnosis. Limited benefit policies, however, pay fixed fees for covered services to either providers or policyholders.

As their name suggests, supplemental plans are not a primary form of insurance. With relatively low benefits paid on a narrow range of claims, supplemental insurance should never be your only coverage. If you have to rely entirely on such coverage for a time, you should plan to get a more comprehensive insurance in the future.

Finding health insurance outside open enrollment remains a challenge. However, you still have options. Contact a licensed insurance professional to determine the best one for you.

Publisher:, Inc.
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