How to get health insurance outside open enrollment?

Individual and Family Health Plans


Annual Enrollment Period:

The annual open enrollment period for most states starts in November 1st and ends in December 15th each year. Insurance plans picked during this period of time are effective on January 1st on the following year. Some states have different deadlines. Contact us to learn more about certain state exchanges.

Do You Have a Special Enrollment Period?

You need a Special Enrollment Period in order to enroll in a qualified health insurance plan outside the Open Enrollment period. To substantiate the Special Enrollment Period, you need to have a Qualifying Life Event. For example: Moved to a new address, changed jobs, lost health coverage, marriage, divorce, having a baby, or change in income. 

If you need help identifying a Qualifiying Life Event, or need to discuss your situation with a licensed health agent feel free to schedule a call with us. 

Alternatively, there are other great options available for you aside from the ACA health plans. For example: Short Term Health Insurance, Indemity plans, Small business group health plans, …etc. 

Note that short Term Health Insurance plans are not available in all states, some US states ban the sale of Short Term Health Insurance plan. Read More.

Short Term Health Insurance Plans:

Short Term Health Plan is a great option in case you missed to enroll in an ACA health plan during open enrollment period. Short Term Health plans can start the coverage the next day and last up to 36 months. Note that different states have different rules about Short Term Health Plans coverage periods and exclusions. Generally, short term health plans are cheaper than ACA plans, and are not eligible for subsidy like the marketplace plans. Read more about short term health plans coverage limits in different states.

Indemity Plans and Pay For Service Plans:

As we discussed above that not all states allow the sale of Short Term Health Insurance Plans, like: Colorado, California, Connecticut, and New Jersey. Thus, you cam sign up for an indemity health insurance plan that protects you from high medical bills in case of illness.

Health Indemity Insurance plans have differnt names and features. For example a Hospital Indemity plan is meawnt to protect you from the expensive out of pocket expenses in case of hospital admission. The plan would pay you back a set dollar amount per day x number of days admitted in the hospital. Note that indemity plans may have waiting periods and other exclusions. Make sure to ask your insurnace agent about the features, coverage limits, and exclusions that plan has.

In addition, you can get an indemity plan that covers doctor visits, hospital admissions, and prescriptions dispense. UnitedHealthcare Golden Rule is known to offer this type of plans. You pay a small premium per month while the plan will reimburse you a pre-determined dollar amount everytime you visit a doctor or get admitted in a hospital. These plans either have an open network where you can see any provider, or a limited network. Always ask your insurance agen about plan limitations, exclusions, or waiting periods on benefits.

Do you have a small business with one additional employee?

Purchasing a small group health insurance plan for you small business would be an ideal solution to get health insurance coverage outside the open enrollment period. In order to get a small business health plan, you need at least 2 full time employees. If you are interested to explore this option or want to learn more about your eligibility to enroll in a small business health plan, contact us here.

Besides, if you do not want to purchase a group health plan due to low census of employee participation, you can have a QSEHRA, Qualifid Small Employer Health Reiburesement Arrangement. Offering QSEHRA allows  your employees (and you) to have  a Special Enrollment period to enroll in a qualified health insurance plan. As an employer you can deduct the reimbursed premiums at the end of the year as a business expense.

Setting up QSEHRA is easy, simply contact us to learn more about your options and process. 

Now you can ask us a question!

We will be very happy to help!

We will reply to this email

Pin It on Pinterest

Share This