Covered California: When can I sign up for a health plan?
By Theresa Struckmeyer
Health Insurance Specialist
One of the most confusing changes that came with the Affordable Care Act is the implementation of open enrollment. Open enrollment is a time where anyone can change their health plan or add a new health plan during the year.Open enrollment is now closed for 2015 but next year’s open enrollment is just around the corner. November 1st 2016- January 31st 2016 is next year’s open enrollment time.
Before the Affordable Care Act, people could change their individual health insurance at any time. This isn’t the case anymore. The reason for open enrollment is simple. Now that Insurance companies cannot deny claims or mandate a waiting period before claims are paid from patients who were previously ill, open enrollment was created. This is to help prevent people from only getting insurance when it’s needed. For instance, Mrs. Jones might forgo getting health insurance now since she is healthy but might want to get insurance later if she finds out she has a serious illness or injury. Mrs. Jones would not be able to do that if it is not during open enrollment or if she does not have a qualifying event that allows for a special enrollment. So this encourages everyone to have insurance at all times because we never know when unexpected injury or illness might affect us.
So what if you need insurance now and it is outside of open enrollment? Do you have to wait to get insurance until next year? Not necessarily. There are several qualifying events that may have occurred in your life that may qualify you for a special enrollment. When a qualifying event occurs, you must sign up for health coverage no later than 60 days after the event occured. Below are the most popular ones.
- Loss of Insurance Coverage- This typically occurs with a job loss or a change of status at work such as going from a W2 employee to a 1099 independent contractor. This can also occur if you go from full time to part time status. Other examples might be losing Medi-cal coverage if you no longer qualify. Also, children who no longer qualify for their parent’s health plan because they turned 26 would fit into this category.
- Change in Family status- Did you just get married, have a baby, adopt a baby, or get divorced? This is a qualify event and is a great time to look at your health coverage to ensure you have exactly the coverage you need for your new family situation.
- Moving- Did you moved into the United States, moved to a different state, or even moved within California to a different area that offers different health plan choices? If you moved within the last 2 months or plan to move shortly, it’s a great time to look at your health plans and select a new one that will better fit your needs.
- Dramatic Change in Income- If your family has had a big change of income, this may trigger a special enrollment specifically if the new income now makes it possible for you to qualify for a tax credit because of a drop in income. On the other hand, if there has been an increase of income and it makes it so that you no longer qualify for a tax credit, this is also a qualifying event.
- Qualifying for Medi-cal- Low income households with income under 138% of the United States Poverty line, can sign up for Medi-cal or Medicaid year round.
If none of these apply to you, then you will have to wait until November 1 to sign up for Health Insurance, however, you can sign up for a temporary health plan now that can cover you while you wait for open enrollment. You can get a quote here for a temporary health plan. The Affordable Care Act and all the changes that came with it can be complicated and confusing. It’s 100% free to have a Covered California Certified Agent help you through your questions. Call us at 1-855-731-888 , Email Us , or chat now with a certified Covered California Agent online.
MP Insurance Solutions is a Covered California Certified Insurance Brokerage. We specialize in Covered California Health Plans, Off Exchange health insurance, Term Life Insurance, Final Expense Insurance, guaranteed income annuities, and dental and vision plans. We specialize in helping those in Southern California including Los Angeles, Riverside, San Bernardino, San Diego, and Orange County California.
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