January 2nd, 2020 BY Jennifer Davis
Open enrollment for major medical insurance ended on December 15th for most of the country. Unless you live in one of the handful of states with longer enrollment periods, that means you won’t be able to get Obamacare health insurance until next November if you missed the signup period.
But it doesn’t mean you can’t get coverage at all.
Major medical insurance is the cream of the crop when it comes to healthcare coverage because these types of plans cover quite a bit. Thanks to the Affordable Care Act (“Obamacare”), major medical plans cover 10 essential health benefits — like maternity care, mental health services and prescription drugs — and provide lots of consumer protections.
The downside is that you can only enroll in these plans during open enrollment, which, as we mentioned, ended last month for most of the country.
There are a couple of options for getting major medical insurance outside of open enrollment. They’re limited, but they exist. And if you can’t get major medical? You can still get health insurance. It just won’t be as comprehensive as the full package available under Obamacare.
Missed the open enrollment period for health insurance in 2020? Here are some options.
Check for a special enrollment period
Special enrollment periods (SEPs) allow you to sign up for major medical insurance as major life changes happen. “Major life changes” include things like:
- Having or adopting a child
- Marriage or divorce
- Losing your job
These aren’t the only kinds of special situations that trigger an enrollment period. You may also qualify based on financial hardships, getting out of jail or gaining citizenship, among several other scenarios.
Point being? If you go through a major shift in your life in 2020, and you don’t have health insurance or don’t have enough coverage, check to see if you can enroll during a special enrollment period.
These SEPs only last for about 60 days in most cases, typically starting from the date the event happened. And you’ll need to prove your case with some documentation. There are other limits involved, so check the requirements carefully if you think you qualify for a special signup period.
See if you qualify for Medicaid and/or CHIP
Medicaid is a joint federal-state program that’s specifically designed to help people with limited income get health insurance, often for free. The Children’s Health Insurance Program (CHIP) extends this concept, offering health insurance to kids in families that make too much for Medicaid but who can’t afford private health insurance.
The ACA expanded Medicaid, making it more available at the federal level to people earning up to 138% of the poverty level. But not all states chose to expand their individual programs, so where you live plays the biggest role in whether you can sign up for Medicaid.
Nevertheless, if you don’t earn much money, you’re pregnant, you have children or you have a disability, you may qualify for Medicaid in your state (or your kids may qualify for CHIP). If that’s the case, then you can sign up anytime during the year. There’s no enrollment period for these programs.
If you’re not sure where to start, head over to HealthCare.gov. The federal marketplace can take your application, or you can contact your state’s individual Medicaid agency.
Get some short term health insurance in the meantime
If you can’t get major medical insurance at all through a special enrollment period or qualifying for Medicaid/CHIP, then you’ll need to look into other options for 2020 health insurance. Our pick? Short term health insurance.
It’s no secret that we sell this kind of coverage, so maybe our bias is showing a little. But hear us out. Short term health insurance is not major medical insurance. There are some significant differences.
That said, short term coverage can provide some level of protection against disastrous medical situations. It tends to cover things like emergency care or medical bills for unexpected problems.
Break your leg while hiking? Your short term plan will likely cover that. Get a bad bout of the flu and have to spend a week in the hospital? That’s where a short term plan comes in.
It’s not coverage for everything. You probably won’t be covered for pre-existing conditions, prescription drugs, preventive care and other types of comprehensive benefits. But short term health insurance isn’t meant to replace a full benefits package. It’s designed as catastrophic coverage, meaning it only pays for things you don’t see coming. In other words, it works like true insurance.
Since you missed open enrollment this year and won’t be able to get major medical until next fall, consider a short term plan to tide you over. These plans can last anywhere from 30 days to 364 days, and they’re renewable for up to 36 months. You can get a plan anytime and drop it when you no longer need it, making them an ideal solution to fill in the gap between major medical plans. Plus, they’re affordable and sold by major insurance companies. You could find a plan for well under $100 a month as an individual depending on where you live.
Major medical insurance is great, and if you can get it, do so. But it’s not always an option.
If you’re looking for coverage in the interim or just need something to act as a stopgap against unexpected (and high) medical costs, short term health insurance could work for you. Just make sure you shop carefully for coverage that fits your temporary needs, and know that short term plans, while effective for some, are not the same thing as major medical.