COVID-19 has tremendously impacted our individual and collective lives for over a year now. It is certainly no surprise to anyone that those impacts have also been felt in the world of health insurance. Unfortunately, the pandemic has resulted in many Americans now being uninsured or underinsured and in need of affordable health insurance. What are their current options?
First, a bit of background about how Americans obtain health insurance for themselves and their families. About half of all Americans receive their health insurance through employer-sponsored health insurance (also called group health insurance). Group health insurance is typically purchased from private insurance companies like Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthcare and the open enrollment period for employees to sign up for health insurance varies from company to company. Many other Americans receive their health insurance from government programs like Medicare and Medicaid or through the military.
But there are millions of Americans who do not fall into any of those categories. If you do not receive health insurance through your employer or through a government program, you might consider exploring your individual health insurance options by contacting a health insurance brokerage company and/or by visiting the Health Insurance Marketplace (also known as the “Exchange”). You may qualify for a subsidy or a reduced health insurance premium payment based on your household income. Indeed, as a sad consequence of the pandemic, many more people now qualify for help paying for their health insurance, including those who may not have been eligible in the past.
The normal open enrollment period for individual health insurance purchased through the Exchange is November 1 to December 15. During that period, Americans who obtain individual health insurance coverage through the Exchange are able to sign up for health insurance, add or drop dependents, and generally make decisions about their health insurance for the following year. During that next year you are typically “stuck” with whatever choices you make (or did not make) during open enrollment unless you are able to provide proof of a qualifying life event such as loss of a job, birth of a child, etc.
However, due to the complications caused by “COVID-19 Era,” the federal government has elected to reopen the Exchange for a Limited Special Enrollment Opportunity from February 15, 2021 through August 15, 2021. During this Limited Special Enrollment Opportunity, no documentation regarding a qualifying life event is required. In fact, any American interested in purchasing their own health coverage can enroll in or make changes to individual health insurance during this Limited Special Enrollment Opportunity. This includes those who are uninsured, underinsured, or already enrolled in a plan and want to switch to a different plan.
It is worth pointing out that you can also still get individual health insurance in the following “normal” ways. First, if you qualify for a Special Enrollment Period due to a life event like losing other coverage, getting married, moving, or having a baby, you can enroll in the Exchange any time. Second, if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can apply any time. However, for many Americans this Limited Special Enrollment Opportunity presents a new, important opportunity to obtain health insurance when they might not otherwise be able to do so.
The information contained in this article is provided for informational purposes only, and should not be construed as legal advice on any subject matter.
Dane Scalise is an experienced insurance and legal advisor, advocate, and consultant. As General Counsel and Insurance Broker for GriffinEstep Benefit Group, he helps people and businesses find creative and intelligent insurance solutions. Established in 1998, GriffinEstep is a leading independent, full-service insurance brokerage company with a team of consultants dedicated to clients, not insurance companies. GriffinEstep provides a unique combination of national expertise and local presence along with the knowledge, insight, and technology necessary to customize the individual insurance needs of its valued clients.
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