.svg){kind=logo}
What Happens If You Miss Open Enrollment for Health Insurance?
If you miss the January 15 health insurance open enrollment deadline, don’t panic—there are still options to obtain coverage.
Here’s how to get health insurance after open enrollment has ended:
OPTION 1: Check If You Qualify for Special Enrollment
- Special Enrollment: Missing the deadline doesn’t rule out getting insured. Check if you qualify for a special enrollment period due to life events like marriage or job loss. Note that illness, pregnancy, or voluntarily dropping coverage do not qualify.
| Qualifying Life Event | Examples |
| Losing Your Current Health Insurance Coverage | – If you lose your coverage for any reason (apart from not paying your premiums). Examples include: you got laid off, aged out of a parent’s plan, or got divorced. – Losing eligibility for Medicare, Medicaid, or CHIP due to a change in income or household circumstances |
| Changes in Your Family | – If you get married or divorced – If you have a baby or adopt a child – If you lose coverage due to the death of your spouse, parent, or guardian |
| Changes in Residence | – If you move to a different ZIP code or county (or parish in Louisiana)- – If you’re a student moving to, or returning from, school/university – If you’re a seasonal worker moving to or returning from, a job location – If you’re moving into or out of a shelter (or transitional housing, such as a halfway house) |
| Other Qualifying Life Events | – Becoming eligible for Medicaid, or being denied after applying for Medicaid during the open enrollment period – Becoming eligible for subsidies that will lower your premiums, if you already have an ACA plan – Gaining membership in a federally recognized tribe – Becoming a U.S. citizen – Leaving jail or prison |
**Note that the following are NOT considered to be qualifying life events:
- Being diagnosed with an illness or getting sick;
- Getting pregnant (although, you can get coverage after you give birth);
- Losing your coverage because you failed to pay your premiums; or
- Voluntarily electing to drop your existing health coverage.
- Becoming eligible for Medicaid, or being denied after applying for Medicaid during the open enrollment period.
OPTION 2: Do You Qualify for Medicaid?
- Medicaid is available year-round to low-income individuals and families, the elderly, and people with disabilities. Eligibility varies by state but often includes those earning up to 138% of the federal poverty level.
OPTION 3: Consider a Short-Term Health Insurance Plan
- Short-term health Insurance is meant for temporary gaps in coverage. It is available anytime and can last up to three months, though it typically doesn’t cover pre-existing conditions or the ACA’s essential benefits.
OPTION 4: Join a Health-Sharing Plan
- Health-Sharing Plans: Faith-based groups offer another alternative. These plans aren’t insurance but a communal way to share healthcare costs. Available year-round, they may exclude services that don’t align with biblical teachings.
OPTION 5: Look Into a Primary Care Membership (“Concierge Medicine”)
- Concierge Medicine: Also known as direct primary care, concierge medicine involves a monthly fee for routine health services, offering an affordable option without comprehensive coverage. This model does not cover major surgery or specialized care but provides personalized and preventive healthcare.
