Getting Insured Outside of Open Enrollment
Having health insurance is crucial to ensuring you and your family members (dependents) have access to affordable and comprehensive medical care when they need it. Without health insurance, medical expenses can quickly add up and put a significant financial strain on everyone living in the Fort Walton, FL area. This is why it’s so important to enroll in health insurance on time — missing the enrollment deadline can result in a coverage gap and potential penalties.
While signing up for insurance coverage on time ensures access to several benefits, without incurring high out-of-pocket costs, at times individuals need coverage outside of the national Open Enrollment time frame. Simerly Ayers Insurance in Florida specializes in helping our clients find affordable health insurance coverage that is tailored to their needs. It’s not uncommon for us to have clients that need to enroll in an insurance plan at a time that is outside of Open Enrollment, and we can help you navigate this complicated matter.
Learn more about how you can still have a medical insurance plan regardless of the timing and contact Simerly Ayers Insurance to talk about your options!
What is Open Enrollment for Insurance?
As we mentioned above, individuals typically make changes to their employer-provided insurance plans or sign for a health insurance plan during a period called Open Enrollment. This time frame — usually between November 1st to January 15th — is when individuals can “shop around” for new insurance plans, switch to a different plan, or make changes to their existing coverage, such as adding or removing dependents or changing their level of coverage.
Open Enrollment is an important opportunity for individuals to review their current health insurance coverage and ensure that they have the right plan to meet their needs and budget for the upcoming year. Our team at Simerly Ayers Insurance understands how important it is to sign off on your health insurance coverage during this time, as it prevents unintentional lapses in coverage.
How You Can Get Insurance Outside of Open Enrollment
The Open Enrollment period is usually the only chance an individual has to finalize his or her health insurance policy before the deadline passes and everything is set. If you do not sign up for a new health insurance plan, or sign off on your existing policy, within the November to January time frame, then the other time changes are allowed is during the Special Enrollment Period (SPE).
The Special Enrollment Period is the only other time when insurance policy changes can be made once the original Open Enrollment period ends. But you can only participate in SPE if you qualify. Read on to learn more about all the SPE qualifications and contact our Simerly Ayers Insurance agency to talk about what your unique situation looks like!
Special Enrollment Period Insurance Qualifications
To be eligible for SPE, individuals must experience what is called a “qualifying life event.” These events can easily impact an individual's health insurance coverage, and several occurrences are considered a qualifying life events, including:
Changes in Your Household:
You may qualify to participate in SPE if you or someone in your household has gotten married; gotten divorced; legally separated from his or her spouse; died; had a baby; or adopted a child.
Changes in Your Residence:
You can also receive SPE qualification if you move to a new ZIP code or county within the United States, or move to the States from another country.
Loss of Health Insurance Coverage:
If you have lost qualifying health insurance coverage, such as turning 26 and no longer being under parental insurance coverage.
Other Situations:
Such as gaining United States citizenship.
During this Special Enrollment Period, individuals who fall into the above categories have a limited amount of time to enroll in or make changes to their health insurance coverage. The length of the SEP and the specific time frame for enrollment vary depending on the qualifying life event. For example, individuals who have recently lost their job may have up to 60 days to enroll in a new health insurance plan, while individuals who have recently had a baby may have up to 30 days to make changes to their existing coverage.
Additionally, to qualify for a Special Enrollment Period, individuals must provide proof of their qualifying life event. This may include documentation such as a marriage certificate, birth certificate, or letter of termination from an employer. If you experience any of the above changes in your situation, let Simerly Ayers Insurance help!
Insurance Coverage Through Medicaid or CHIP
If you do not qualify to partake in the Special Enrollment Period, it’s still possible to have health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). These are government-funded programs designed to provide health insurance coverage to individuals and families who may not be able to afford or access private health insurance. Unlike private health insurance plans, individuals can apply for Medicaid and CHIP at any time throughout the year, regardless of whether or not it is Open Enrollment.
Medicaid is a joint federal and state program that provides health insurance coverage to low-income individuals and families, pregnant women, children, and people with disabilities across Florida. CHIP, on the other hand, is a program that provides health insurance coverage to children and pregnant women in Florida who may not be eligible for Medicaid but also cannot afford private health insurance. What’s important to understand about these options, however, is that eligibility can vary based on several factors, including income, family size, and age.
Discover Your Options With Simerly Ayers Insurance
Even if you miss out on Open Enrollment, it is still possible to get the essential health insurance coverage you need! Simerly Ayers Insurance can help you identify what the best course of action is for you and your family. Contact our agents today and learn more about how you can keep your medical costs low with the help of a medical insurance plan that works for you!