Purchasing health insurance through the ACA marketplace/ state exchange is not like purchasing other types of insurance. There are rules and regulations in place that limit when you can purchase health insurance and you have to meet certain criteria to enroll.
Additionally, insurance companies may ask for personal documents as proof to enroll, which could add an extra step to the process and make it that much more difficult.
Here are the basics of when you can enroll:
Open Enrollment Period (OEP)
Open Enrollment Period runs from November 1- December 15 every year. Sometimes, it is extended to January 15, but that is dependent on your state rules. These dates can be subject to change year to year, but generally, if you want to enroll in a plan starting January 1st, your application must be submitted by December 15th.
Many people enroll during this time because they currently have insurance and need to renew, change their plan, or use it as an opportunity to enroll for the first time so they can have insurance in the new year.
Since OEP is so short, it can be easy to miss deadlines, so it is best not to wait until December 15th to enroll. Not only will this lead to stress, but if you need to provide other documents with your application and can’t get them in time, you won’t get the start date you want.
Working with a broker is the best way to enroll during this time. It is an incredibly busy time for their business, so being respectful of their time and getting your application submitted early is best.
Special Enrollment Period (SEP)
Outside of Open Enrollment, (February-October), you must meet certain requirements to enroll in health insurance. This is where the Special Enrollment Period applies.
In order to enroll in health insurance, you must have a SEP. Examples include:
- Changes in household size (married, divorced, baby, died)
- Loss of insurance coverage
- Moved (new state, zip code, or college)
- Offered employer coverage
If one of these life-changing events occurred, you have 60 days to get insurance. If you miss the 60 days, you have to wait until OEP to enroll.
Any time of year
Some states offer private insurance plans that are not associated with the ACA. With these plans, you can enroll any time of year, even after the 60 days your life event occurred. However, this is not available in all states, so check with your broker to make sure this option is available. If it is not, your only option is to get a plan on the ACA marketplace or your state exchange. If you miss deadlines, you have to wait until the next Open Enrollment Period to enroll.
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