You can obtain health insurance coverage outside of Open Enrollment if you qualify for a Special Enrollment Period (SEP). The Federal Government defines an SEP as "A time outside of the Open Enrollment period during which you and your family have a right to sign up for health coverage following certain life events that involve a change."
So the answer is a big fat no unless you qualify for an SEP. It's that simple. Or is it? The events listed below qualify as an SEP. However, enrollment must take place for yourself and any eligible dependents within 60 days if any of the following events below occur.
Sounds confusing doesn't it? You bet it is! An SEP is not your only option of obtaining coverage. Another option is a short-term policy until Open Enrollment resumes November 15, 2014. With all this confusion, it's a wonder most individuals haven't a clue where to turn. That takes the "care" right out of healthcare, doesn't it? However, an agent trained to counsel both on and off the marketplace will be able to assist you. It is extremely important to ask your agent if he/she is a Federally Facilitated Marketplace agent. It's also helpful if he/she represents all major carries in your region!
So, here is that list of SEP qualifications:
• Loss of group coverage because of termination of employment (except for
gross misconduct) or reduction in hours.
• Loss of group coverage because of the death of the enrollee.
• Loss of group coverage because of a divorce or legal separation.
• Your dependent loses group coverage because
of loss of eligibility as a dependent child.
• Loss of group coverage because the group enrollee’s initial enrollment for Medicare.
• Loss of minimum essential coverage (failure to pay premium or a rescission of coverage allowed under federal law does not qualify as a loss of minimum essential coverage).
• Newly acquired dependents through marriage, birth, adoption, or placement for adoption.
• If you become a citizen, national or lawfully present individual in the U.S.
• If you are qualified, but experience an error in enrollment.
• If you are enrolled in another Qualified Health Plan and you successfully demonstrate to the Exchange that your Qualified Health Plan has substantially violated a material provision of its contract.
• If you are newly eligible or lose eligibility for advance payment of the premium tax credit, or you experience a change in eligibility for cost sharing reductions.
• If you become eligible for new Qualified Health Plans offered through the Exchange because of a permanent move.
This law is constantly shifting. Stay up to date with a broker who understands the law!
If you found this helpful, please share with others:
Sounds confusing doesn't it? You bet it is! An SEP is not your only option of obtaining coverage. Another option is a short-term policy until Open Enrollment resumes November 15, 2014. With all this confusion, it's a wonder most individuals haven't a clue where to turn. That takes the "care" right out of healthcare, doesn't it? However, an agent trained to counsel both on and off the marketplace will be able to assist you. It is extremely important to ask your agent if he/she is a Federally Facilitated Marketplace agent. It's also helpful if he/she represents all major carries in your region!
So, here is that list of SEP qualifications:
• Loss of group coverage because of termination of employment (except for
gross misconduct) or reduction in hours.
• Loss of group coverage because of the death of the enrollee.
• Loss of group coverage because of a divorce or legal separation.
• Your dependent loses group coverage because
of loss of eligibility as a dependent child.
• Loss of group coverage because the group enrollee’s initial enrollment for Medicare.
• Loss of minimum essential coverage (failure to pay premium or a rescission of coverage allowed under federal law does not qualify as a loss of minimum essential coverage).
• Newly acquired dependents through marriage, birth, adoption, or placement for adoption.
• If you become a citizen, national or lawfully present individual in the U.S.
• If you are qualified, but experience an error in enrollment.
• If you are enrolled in another Qualified Health Plan and you successfully demonstrate to the Exchange that your Qualified Health Plan has substantially violated a material provision of its contract.
• If you are newly eligible or lose eligibility for advance payment of the premium tax credit, or you experience a change in eligibility for cost sharing reductions.
• If you become eligible for new Qualified Health Plans offered through the Exchange because of a permanent move.
This law is constantly shifting. Stay up to date with a broker who understands the law!
If you found this helpful, please share with others:
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