What are my health insurance options outside of Open Enrollment?

While many people enroll in their health insurance during the Open Enrollment Period (OEP, for those under 65 years old) and the Annual Enrollment Period (AEP, for Medicare beneficiaries), those are not the only times in the year where you can sign up for health coverage. There are still options available outside of OEP and AEP for individuals, families and businesses looking for health coverage.

Health coverage options outside of Open Enrollment

Special Enrollment Period (SEP)

  • Change in household: If you have a significant change in your household status, you will be eligible to explore health insurance options. Examples include marriage or children (birthed, adopted or fostered).
  • Loss of coverage: Loosing minimum essential health coverage qualifies you to explore and enroll in a new plan. Examples include losing job-based coverage, turning 26 and losing access to a parent’s health plan, and losing eligibility of Medicare or Medicaid.
  • Change in residence: Health insurance plans are dependent on your primary residence, so moving offers new health coverage options available to you and your family. Examples include moving to a different zip code, a student moving to or from where they attend school, a seasonal worker moving to or from where they live and work, and a move to or from a shelter or transitional housing.
  • Change in eligibility: If you experience a shift in eligibility, an opportunity opens to revisit your healthcare coverage. Examples include a change in income that affects the coverage you qualify for, becoming a U.S. citizen, gaining or maintaining the status of a federally recognized tribe or an Alaska Native Claim Settlement Act Corporation shareholder, and leaving incarceration.

Supplemental Health Insurance

Supplemental coverage options available outside of the Open Enrollment Period include dental, vision, disability, critical care, life, accident and other wellness solutions. For individuals under 65, short-term insurance plans are also available in most states and can act as a bridge to get you to the next Open Enrollment. Please note – not all options are Affordable Care Act-compliant outside of Open Enrollment.

Health coverage options outside of Annual Enrollment for Medicare

MedicareInitial Enrollment Period (IEP)

For those new to Medicare, the IEP offers the first opportunity to enroll in Parts A and B through the Social Security Administration. Your IEP begins three months before the month of your 65th birthday and ends three months after the month of your 65th birthday (for a total of 7 months).

General Enrollment Period (GEP)

The GEP is open every year from January 1 - March 31 and allows you to enroll in Medicare Part B if you missed the deadline during the AEP. Beneficiaries who have to pay a premium for Medicare Part A must sign up for Part A during the GEP if you didn’t enroll during your initial enrollment period. However, you may experience a late enrollment penalty and coverage does not go into effect until July 1.

Medicare Supplement Open Enrollment Period

This only happens once unless you meet certain qualifications. It begins the month you turn 65 and lasts for a period of 6 months. During that time, you may enroll in a Medicare Supplement plan if you’re already enrolled in Parts A and B.

Medicare Advantage Open Enrollment Period

This lasts from January 1 - March 31 every year. If you are enrolled in a Medicare Advantage plan already, you can make changes to your coverage during this period. Some restrictions may be in place for changing plans including once you switch during the window period, and the plan is locked in for the remainder of the year.

Special Enrollment Period (SEP)

You may qualify for an SEP if you lose or need to alter your Medicare plan due to certain life events and circumstances, such as changes in your employment status or residence.

Health coverage options for businesses

Health coverage options for businesses are available year-round. Health Reimbursement Arrangements, also known as HRAs, provide individual health solutions for employees and their families. HRAs are not group insurance or a one-size-fits-all solution – instead, this health coverage option offers an employer contribution to an approved health insurance solution. HRAs offer flexibility for employees and allow them to choose the best health coverage plan for their specific needs.

Have questions?

LIG Solutions is an OGR supply partner with licensed advisors who can walk you through the options available to you and your family outside of OEP or AEP. We work with national insurance carriers across the U.S. and has access to a full suite of supplemental coverage, Medicare/supplementals, and HRAs/business options.

Our team offers transparent, free consultations regarding your health insurance options. We’ll discuss what you’re looking for in a plan as well as available options that would suit your specific situation. As brokers, we have access to all private insurance and ACA Marketplace health coverage plans, so you can feel confident that all options will be considered and any questions you have will be answered. We’re here and ready to help you find the best plan for your needs and budget. Learn more at LIGmembers.com/OGR.

*Disclaimer: Medicare is available to some individuals under the age of 65 in limited circumstances. LIG Solutions is not affiliated with the U.S. government or federal Medicare program. LIG Solutions complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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