Special Enrollment Periods (SEP’s)

During the healthcare reform over the past few years, one of the major changes that came about has to do with when you can sign up for health insurance.

You hear all about Open Enrollment, especially later in the year when Open Enrollment is about to start. Open Enrollment typically is November 1 – January 31.

So what do you do if you need health insurance outside of those dates?

There are 3 options you can look at.

1. Do you qualify for a Special Enrollment Period (see below)
2. Do you qualify for Medicare, Medicaid, or CHIP
3. You can look at a catastrophic plan

Special Enrollment Periods

Special Enrollment Periods are available to individuals and households who have a change in their lives that could affect the current health coverage they have.

These include a change in household size, change or residence or income, change in status / citizenship. Also, if you lose your primary health insurance due to an employer cancelling or changing their plan, you can qualify for an SEP.

Household changes include getting married, divorced or legally separated, had a baby, adopted a child or had a child place with you for foster care, or death

Change in residency is defined as moving to a new zip code. There are also provisions for college students, foreigners moving to the US, and seasonal workers.

You can learn more about Special Election Periods on Healthcare.gov. If you’d like help navigating their website, or dealing with the paperwork, give us a call. That’s what we’re good at.

Catastrophic Plans

Catastrophic plans are designed to give you coverage for major accidents or health issues that come into your life (such as a broken bone or an appendix rupture) but they generally do not provide coverage for visits to the doctor about a cold or an ear infection.  And there is generally no prescription drug coverage. This coverage is better than having no coverage at all, but may not meet all your health insurance needs. Your best option is to talk with a Health Insurance Specialist to determine if you can get coverage through a Special Enrollment Period.