Life happens, and you lost track of time and missed the Open Enrollment Period (OEP). Although OEP, which runs from October 15 through December 7 each year, is the best time to change your health care plan, don’t worry. If you would like to enroll in Medicare, there are still several ways to get health insurance after Open Enrollment.
Special Enrollment Period
A lot can happen in 12-months to an individual or a family. Medicare is fully aware of this and has put measures into place to help people get healthcare coverage after the deadline. Medicare calls these happenings a “qualifying life event (QLE).” A QLE is generally something that happens to an individual, or a family that causes them to either lose healthcare coverage or immediately need to make a plan change. However, not all life changes are created equal, and some will not qualify during the Special Enrollment Period.
If you or your family has had any of the following qualifying life events occur, you could be eligible during the Special Enrollment Period to sign up for coverage:
- If you got married married.
- If you are having a baby or adopting a baby.
- If you are getting off your parent’s health care plan in favor of your own.
- If your insurance company cancels your plan.
- If you have just become a US citizen.
- If you have just been released from incarceration.
- If you are a college student returning from college.
- If your spouse has died, and you have lost coverage.
- If you are a seasonal worker.
- If you have gained membership in a federally recognized tribe.
As we said before, not all qualifying life events are created equal. Some life events may not qualify for enrollment during the Special Enrollment Period. Here are a few of the higher searched life events that ultimately will not qualify as a QLE:
- Voluntarily dropping your health care coverage
- Learning that your primary physician is not in your network.
- You missed the open enrollment period due to being on vacation.
- Your most current healthcare insurance policy was canceled due to nonpayment of premium.
Another way that a person can get health insurance after Open Enrollment is through Medicaid. Medicaid is a government program that is funded at the state and federal level that was designed to help individuals with basic health care. However, not everyone who applies will qualify. Understanding how Medicaid works could be a great option for your situation to secure health insurance for you and your family.
What Does Medicaid Cover?
Just like Medicare, Medicaid wasn’t designed to cover everything. However, it does cover a lot of the basic health care that most individuals tend to need. Also, Medicaid can be enrolled in at any time of the year. Healthcare provided by Medicaid could consist of any of the following:
- Early prevention screenings, and diagnostics for people 21 years of age or older.
- If you received care in a rural health clinic or a health care center. This would be covered.
- Family planning services
- X-ray and laboratory work services.
- Medical transportation
- Covers care you received from a nurse, midwife, nurse practitioner, or physician.
Legal Immigrants and Medicaid
If you are an American citizen and qualify for Medicaid, you have access to all the program has to offer. However, if you have Immigrant Status, the same cannot be said. If you have Immigration Status, it does not automatically mean that you are not eligible to receive Medicaid. It just means that the decision is up to the particular state on whether or not they will offer coverage to citizens who are not technically US citizens just yet.
Legal Immigrants who entered the country before 1996 may be eligible for full Medicaid.
Legal Immigrants who entered the country after 1996 can only receive full Medicaid after they have been in the US for at least five years.
Illegal Immigrants who entered the country before or after 1996 can receive some form of Medicaid services. However, the coverage will only be extended to emergency services and not the full benefit of Medicaid.
Children’s Health Insurance Program (CHIP) was created to provide health insurance for children (Newborn through age 18) whose parents do not meet the Medicaid income requirements. At its basic level, CHIP is the same in all states. However, the coverage can vary in its entirety as applicable per state. Each state governs how the full coverage of CHIP is used.
To learn more about your options after the Open Enrollment Period, contact the experts at 855-614-5057. Our licensed insurance experts will be happy to answer any questions you have.