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Can I Buy Insurance Outside Of Open Enrollment

Note that some triggering events will only qualify you for a SEP in the health insurance Marketplace; they do not apply in the outside market. For example, if you gain citizenship or lawfully present status, the Marketplace must provide you with a special enrollment opportunity.

can i buy insurance outside of open enrollment

As described below, Medicaid and CHIP enrollment are available year-round for eligible applicants, and Native Americans can also enroll year-round. And enrollment is available nationwide when people experience certain qualifying events. But there are also some states where other types of coverage can be obtained outside of open enrollment:

Depending on your circumstances, your opportunities to enroll after the end of the annual open enrollment period may be limited. But you may find that you can still get coverage without having to wait for the next annual open enrollment period.

And without a qualifying event, major medical health insurance is not available outside of general open enrollment, on or off-exchange. This is very different from the pre-2014 individual health insurance market, where people could apply for coverage at any time. But of course, approval used to be contingent on health status, which is no longer the case.

In most of the United States, in order to buy private health insurance after open enrollment, you must qualify for a special enrollment period (SEP), which usually lasts 60 days from the date of a qualifying life event.

If you have a qualifying event, you may get a special enrollment period (SEP) to buy an individual health plan. This means you can enroll in or change your health insurance plan outside the standard open enrollment period. For some types of special enrollment events, special enrollment periods last 60 days from the date of the qualifying event (see below for examples). However, for the most common occurring special enrollment events, such as a loss of coverage, you may also enroll 60 days in advance of the special enrollment event. If you don't qualify for a SEP, you'll need to wait until the next open enrollment period.

The Open Enrollment Period for the 2023 coverage year ended January 31st. You may be eligible to enroll in coverage outside of open enrollment if you have a major life event or meet a certain income level.

Do you have questions about the open enrollment waiver process? See below for a list of our most frequently asked questions. If you did not purchase health insurance during the last open enrollment period, you may still be eligible to buy health insurance by requesting a waiver from the Office of Patient Protection (OPP).

The open enrollment period is a specific time of year when consumers can buy health insurance. This open enrollment period is set by state and federal law and may change each year. Consumers who receive health insurance benefits from their employer may have a separate designated period when they can make plan selections.

Massachusetts residents who missed the last open enrollment period and have not experienced a qualifying life event may request an open enrollment waiver. The Office of Patient Protection reviews waiver requests and typically grants open enrollment waivers to individuals and families who:

No. If you are seeking to enroll in employer-sponsored health insurance or other insurance obtained as a member of a group, you are not eligible for an open enrollment waiver. Your employer may limit health insurance enrollment to certain times during the year. You should talk to your employer about your needs.

Yes. If granted an open enrollment waiver by OPP, you must seek to enroll in health insurance from the health insurance company that initially denied your enrollment. If you enrolled through the Connector or a broker, you should return to the Connector or the broker who issued your initial enrollment denial.

Yes. The open enrollment waivers may only be used within 30 days from the date on the letter. If you did not use your open enrollment waiver to enroll in health insurance within 30 days, please contact OPP.

Such qualifying life events include marriage, childbirth, and other major happenings. In most cases, you have 60 days after the date that triggered the qualifying life event to purchase major medical individual or family health insurance coverage. This 60-day period is sometimes referred to as your special enrollment period.

If you have lost your health care coverage as a result of losing your job or no longer qualifying for state health insurance, then, as long as you can prove it, you will be allowed to take advantage of a special enrollment period.

Changes in your household that would allow you to be able to make changes to your health insurance coverage or apply for a new plan include separation, divorce, or marriage. Most insurance plans will request proof of the household change for you to qualify for the special enrollment period.

A change in your citizenship status is considered a qualifying life event, allowing you to obtain insurance during a special enrollment period. Insurance rules vary for citizens and non-citizens, so be sure to report any citizenship changes.

It is easy to determine if you qualify for a special enrollment period. Keep in mind that you have 60 days from the qualifying event to make changes to an existing policy or sign up for one of the many health insurance plans.

Private health insurance is purchased by an individual instead of a group. The best private health insurance policies are available for individuals to buy outside of the insurance marketplace. These policies can be written for individuals or families. A private health insurance policy is capable of filling in the gaps left by group policies and Medicare/Medicaid. A private policy may also offer a more comprehensive list of benefits.

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. (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 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.

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.

You can buy or change an existing health plan outside of open enrollment if you've recently had a qualifying event in your life. We call this a special enrollment period. To learn more, see How do I buy or change a plan during special enrollment?

Individual/Family and Group health coverage sold in California only allows new membership during an annual open enrollment period. Enrollment works this way because if people were allowed to purchase insurance anytime, people could wait until they got sick and the system wouldn't work.

There are exceptions to the annual open enrollment period. These are called qualifying life events and if you experience one or more of them, you can buy new coverage or change your existing coverage. Below is a list of the qualifying life events:

For ACA plans, some state-based markets may have open enrollment periods that differ from federal-based marketplaces, as well as special enrollment periods. For UnitedHealthcare Individual & Family ACA Marketplace plans, open enrollment for most states is November 1 through January 15.

If you have both Medicaid and Medicare benefits, you could be eligible for a Dual Special Needs Plan, or D-SNP. Those who qualify for this type of Medicare Advantage plan can switch to a new plan at any point during the year, not just during open enrollment.

You may also be able to qualify for financial assistance through Connect for Health Colorado outside of open enrollment if you have experienced a qualifying life event such as losing your job-based coverage, getting married, or having a baby. Visit for more information.

Coloradans can use the Connect for Health Colorado Marketplace to shop for private health insurance plans and find out if they qualify for financial assistance to lower their health care costs. When the open enrollment period is closed you may still be able buy insurance through Connect for Health Colorado if you have experienced a qualifying life event.

If you are a Medicare consumer, Medicare has several different enrollment periods, including its own Special Enrollment Period. However, unless you have low income (qualifying for a program like Medicaid, the Medicare Savings Program, or Part D Extra Help), a late enrollment into Medicare may result in a higher premium, according to If you qualify for one of these low-income programs, you may be able to expand your eligibility for certain parts of Medicare, as well, outside of the usual enrollment periods described above.

Some life changes trigger what is called a "special enrollment" period. Special enrollment lets you get or change your private coverage outside of open enrollment. Special enrollment periods can be as short as 30 days, so you should act fast. The New York State of Health (NYSOH) has issued Frequently Asked Questions (FAQ) on Special Enrollment Periods for consumers to understand their options during the COVID-19 pandemic. The New York State of Health has implemented a COVID-19 Special Enrollment Period for private health insurance through September 15, 2020. 041b061a72


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