You Can Qualify for Special Enrollment
Can you still sign up for health insurance during Special Enrollment?
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What is Special Enrollment?
Special Enrollment is a period outside of Open Enrollment where you can sign up for health coverage in the ACA marketplace under certain conditions. In California, this process takes place through Covered California. During this time, those who have a qualifying life event may sign up for the Affordable Care Act (ACA), or Obamacare, health insurance coverage.
Many people don’t know that anybody can sign up for health insurance during open enrollment (usually during the last few months of the year and into the beginning of the next). California runs its own health insurance marketplace, so residents apply directly through Covered California. Other states that don’t operate their own marketplace use the federal site, HealthCare.gov, which follows nationwide enrollment rules.
Outside of that window, you can still enroll through the Special Enrollment Period if you experience a qualifying life event. At Freeway Insurance, our bilingual agents can walk you through how to apply and which plan to pick.
- California Health Insurance – Special Enrollment is Available
Special Enrollment Quotes are Available Now
Many people may qualify for Special Enrollment and not even know it. Eligibility often changes due to events such as a move, a change in income, or loss of previous coverage.
What is a Qualifying Event for Special Enrollment Period?
In order to enroll for ACA marketplace insurance, or Obamacare, during Special Enrollment, you must have a qualifying life event. Covered California follows federal guidelines, which include situations such as:
- Lost your healthcare (individual plans, Medi-Cal, Medicare, employer-sponsored and COBRA)
- Got married
- Had a baby or birth adoption or placement of a fostered a child
- Either gained a dependent or became a dependent
- Got divorced/legally separated and lost your health insurance
- Changed your primary residence
- A change in household income
- Lost Medi-Cal coverage after redetermination
- And more
You generally have 60 days from the qualifying event to enroll in or change your health plan.
How Much Does Affordable Care Act Cost During Special Enrollment?
Prices during Special Enrollment are the same as during Open Enrollment. If you live in California, your health plan options and financial assistance are available through Covered California — the state’s ACA marketplace. Depending on the size of your family and your income, Marketplace Healthcare may be free or greatly reduced through stipends the government offers to help pay for health insurance.
Due to ACA requirements, all health plans sold through the marketplace include essential health benefits, such as preventive care, maternity services, prescription drugs, and an annual wellness check at no cost.
The marketplace consists of plans from many different insurance companies and is divided into 4 tiers (Bronze, Silver, Gold and Platinum) based on cost and coverage. Insurers cannot deny or raise rates due to pre-existing conditions.
If you don’t qualify for a stipend, you may find that Marketplace health insurance plans are fairly expensive. However, Freeway’s licensed agents can check if you qualify for Medi-Cal or state premium assistance, which can make coverage far more affordable.
Why Should I Buy Health Insurance During Special Enrollment?
If you missed the Marketplace Open Enrollment period and you want to get health insurance, you should do so during Special Enrollment if you have a qualifying life event. In California, residents are required to maintain health coverage or pay a penalty when filing state taxes unless they qualify for an exemption.
But beyond avoiding penalties, having health insurance matters for other reasons:
- Continuity of care. You can get yourself and your family established with medical practitioners who will come to know you and your unique needs. You won’t have to explain everything from scratch by using strangers in an emergency department at some hospital or clinic.
- Cost savings. Your health insurance plan gives you access to medical people and facilities at a greatly-reduced price, especially if you use in-network providers.
- Free preventative care. You and your family will have access to free vaccines, free cancer screenings and free annual wellness checks. Nipping a problem in the bud early can save a lot of suffering later on.
These are just a few of the benefits of maintaining coverage. At Freeway Insurance, our bilingual and licensed agents can guide you through the Special Enrollment process, help you compare plan tiers, and determine your eligibility for government assistance or Medi-Cal.
Get a Free Health Insurance Quote during Special Enrollment
Signing up for healthcare insurance for you and your family means you’ll be protected when it is necessary. Freeway Insurance can help you. Just give us a call at 800-777-5620, get a quote for health insurance online or stop by one of our many locations.