How can I get health insurance after Open Enrollment has passed?

Open Enrollment Period is the time when anyone can enroll in Obamacare health plans each year. Want to know how to get health insurance after Open Enrollment has passed? You have two main options for getting health care for a given calendar year.

Special Enrollment Periods

First, you might be able to enroll in health coverage through the Affordable Care Act's Health Insurance Marketplace if you have had a Qualifying Life Event (QLE) that makes you eligible for a Special Enrollment Period.

Most Qualifying Life Events fall into one of five major categories:

• A loss of health insurance coverage
• A change in the size of your household
• A move to a new zip code
• Gaining citizenship
• Release from incarceration.

Contact a member of the HealthSherpa Consumer Advocate Team to determine if you qualify for a Special Enrollment Period. The Consumer Advocate Team can be reached at (872) 228-2549. If you'd like more information, grab our free step-by-step guide to enrolling in Marketplace health insurance here.

You can shop for health plans, compare prices, and see what kinds of subsidies and tax credits you might qualify for here. You can also enter your zip code below to see available plans in your area. 

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Medicaid and CHIP

Second, you can see if you might qualify for Medicaid or CHIP (Children’s Health Insurance Program) if you need health insurance after Open Enrollment. These are both government-funded and -administered health insurance programs for low-income Americans. You can enroll in these programs at any time during the year. You do not need to wait for Open Enrollment to sign-up for Medicaid or CHIP.

Medicaid eligibility is largely based on income. Right now in the U.S., Medicaid covers one in four children and one in five adults. 32 states plus Washington, D.C. have expanded their Medicaid programs to cover individuals and families with household incomes up to 138% of the Federal Poverty Level, which is $17,236 for an individual or $29,435 for a family of three. 

CHIP provides low-cost health insurance to children up to the age of 19 whose families earn too much to qualify for Medicaid in their state. In some states, CHIP also covers pregnant women. 46 states plus the District of Columbia make CHIP eligible for children whose families earn up to or above 200% of the Federal Poverty level, or $50,200 for a family of four. 24 of those states offer CHIP to children in families who earn up to 250% of the Federal Poverty Level, or $62,750 for a family of four. 

What to know about short-term health insurance

One option that experts do not recommend is getting a short-term health insurance plan instead of regular health insurance. This is because short-term plans do not offer the consumer protections laid out by the Affordable Care Act—they typically don't cover pre-existing conditions, maternity coverage, prescription drugs, or other benefits that the Affordable Care Act requires in Marketplace plans. These plans are only sold outside of the Marketplace by insurance companies. If you need health insurance after Open Enrollment has passed, you are best pursuing other options if possible.