When it comes to buying individual health insurance, understanding enrollment periods and available options is crucial. While there are specific enrollment periods, there are also options for purchasing outside of these periods. Let’s explore the ins and outs of buying individual health insurance.

Health Insurance Enrollment Periods

Private health insurance coverage must be purchased during open enrollment like other types of health insurance. Everyone has the chance to purchase private health insurance or change health insurance plans purchased on the exchange during the Open Enrollment Period, or OEP. OEP is an annual event, and in most cases, it runs 24 hours a day, 7 days a week, from November 1 to December 15. This date can vary a bit by state so be sure to check the OEP dates for your state.

The annual OEP is the time to buy ACA-compliant, Qualified Health Plans (QHPs) without complication. You will need to evaluate your choices and apply for coverage before the end of the OEP. But there are circumstances in which you can get those plans outside of open enrollment periods, like if you’re eligible for special enrollment due to a qualifying life event.

How to Get Health Insurance after Open Enrollment

Once that Open Enrollment window closes, things change for consumers in need of individual or family health insurance. To purchase ACA-compliant insurance plans on the exchange, you must meet the criteria for special enrollment.  You do still have a few options if you fail to qualify for special enrollment but still need some kind of coverage until the next open enrollment period comes up. eHealth has other options that ease the burden while you wait, such as short-term health insurance and discount prescription drug plans. These are not Obamacare-compliant but can be effective alternatives for someone looking for some sort of medical coverage.

Special Enrollment Periods

To purchase ACA-compliant insurance plans on the exchange, you must meet the criteria for special enrollment. Healthcare.gov (the federal marketplace or exchange) defines Special Enrollment Period as the time outside of the private health insurance open enrollment period that people with special circumstances can buy individual and family policies.

You may be eligible for special enrollment if you have a qualifying life event, including domestic developments, residency changes, or loss in coverage. You generally have 60 days after a qualifying life event to apply for a new qualified health insurance plan.

If you are unsure if you meet the criteria for a special enrollment, an eHealth licensed insurance broker can help you figure that out and find an ACA-compliant plan if you’re eligible to sign up.

Medicaid and CHIP Enrollment

Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health coverage to eligible individuals and families with low incomes. Eligibility criteria vary by state, but typically include factors like income, family size, and citizenship status. Coverage includes essential health benefits such as doctor visits, hospital stays, prescription drugs, and preventive care.

COBRA Coverage

COBRA, or the Consolidated Omnibus Budget Reconciliation Act, allows eligible employees and their dependents to continue their group health insurance coverage for a limited time after experiencing a qualifying event such as job loss, reduction in hours, or divorce. To qualify, individuals must have been covered by a group health plan sponsored by a covered employer. COBRA coverage typically lasts up to 18 or 36 months, depending on the qualifying event.

Short-Term Health Insurance

Short-term health insurance provides temporary coverage for individuals who need health insurance for a limited period, such as during a gap in coverage or while transitioning between jobs. These plans offer flexibility in coverage duration, typically ranging from a few months to a year. However, they may not cover all essential health benefits and may have limitations on pre-existing conditions. Eligibility criteria vary by insurer and state regulations.

Health Insurance Marketplace Special Enrollment

The Health Insurance Marketplace offers special enrollment periods for individuals who experience qualifying life events such as marriage, birth or adoption of a child, loss of other health coverage, or relocation to a new area. During these special enrollment periods, individuals can enroll in a health insurance plan or make changes to their existing coverage outside of the annual open enrollment period. Eligibility criteria for special enrollment vary depending on the qualifying event.

Private Health Insurance Plans

Private health insurance plans are offered by commercial insurers and provide coverage for medical expenses such as doctor visits, hospital stays, prescription drugs, and preventive care. These plans may be purchased individually or through an employer-sponsored group plan. Eligibility criteria and coverage options vary by insurer and plan type, offering a range of choices to meet diverse healthcare needs.

Factors to Consider when Purchasing Health Insurance

When you’re in the market for health insurance, there are several key factors to keep in mind to ensure you’re getting the best coverage for your needs. Let’s break down three essential considerations: cost, coverage, and eligibility.

Cost

One of the first things to consider when purchasing health insurance is the cost. This includes not only the monthly premium you’ll pay for the policy but also any deductibles, copayments, and coinsurance amounts you’ll be responsible for. Premiums can vary based on the plan type, coverage level, and your age. Deductibles are the amount you must pay out of pocket before your insurance kicks in, while copayments and coinsurance are the portion of costs you share with your insurer for covered services. It’s crucial to evaluate your budget and determine what you can afford in terms of premiums and out-of-pocket expenses.

Coverage

The next factor to consider is the coverage provided by the health insurance plan. Different plans offer varying levels of coverage for medical services, prescription drugs, and other healthcare needs. Typically, health insurance plans cover essential services like doctor visits, hospital stays, prescription medications, preventive care, and specialist visits. However, the extent of coverage may differ between plans, so it’s crucial to review each plan’s benefits carefully.

Eligibility

Finally, you need to consider your eligibility for different health insurance options. Eligibility criteria can vary depending on the type of plan you’re considering, whether it’s through an employer, a government program like Medicaid or Medicare, or a private insurance marketplace. Factors such as income, age, employment status, and residency may impact your eligibility for certain plans. For example, Medicaid is typically available to low-income individuals and families, while Medicare is available to individuals aged 65 and older or those with certain disabilities. Private health insurance plans may have eligibility requirements based on factors such as employment or enrollment periods. It’s essential to understand the eligibility requirements for each plan and determine which options you qualify for.

By carefully considering cost, coverage, and eligibility, you can make an informed decision when purchasing health insurance that meets your needs and fits your budget. Remember to compare different plans, evaluate their benefits and costs, and choose the option that offers the best combination of affordability and coverage for you and your family.

Penalties for Remaining Uninsured

Are you aware of the penalties for remaining uninsured? Let’s break it down. If you choose not to have health insurance coverage, you might face financial penalties. These penalties are usually enforced through your annual tax return. But how much are these penalties, and who’s affected? You can find out more about the penalties for remaining uninsured in our comprehensive guide here. Don’t risk facing hefty fines—get informed about your options today!

Buying Private Health Insurance: FAQs

When can I buy private health insurance?

Private health insurance coverage can be purchased during the Open Enrollment Period or after a life-changing event occurs that allows for a 60-day special enrollment period. You cannot buy private health insurance outside of these specific situations.

Can I buy health insurance on my own?

Yes! You can buy individual health insurance through the Health Insurance Marketplace or private carriers. If you’re not sure which private health insurance plan is right for you, you can contact the agents at eHealth who will walk you through the process of finding the best health insurance plan for your situation.

Is it cheaper to buy private health insurance?

Yes, it can be cheaper to buy private health insurance, as there are often more affordable options available compared to other types of health insurance plans. However, the cost depends on various factors such as your age, location, coverage needs, and the insurance provider. It’s essential to compare different private health insurance plans to find the most cost-effective option that meets your needs.

Concerned about the costs of private health insurance? Visit eHealthinsurance.com to explore your options and discover some of the top private health insurance plans all in one convenient location. Quality coverage doesn’t have to break the bank—find the right plan for you today!

Find health coverage that’s right for you

Check out the variety of individual and family health insurance options that eHealth has to offer. eHealth agents are here to help you find the coverage option that best meets your needs—now and in the future. Whether you need individual health insurance, dental insurance, or a combination, you can find what you need on eHealth. You can view the insurance options available to you at your convenience or contact an eHealth representative via chat or over the phone.