If you missed ACA open enrollment, you may fear that you are doomed to live the next year without health insurance or are stuck with the same plan as last year. But don’t give up hope! This blog article will give you the knowledge you need to ensure you have healthcare coverage you can afford this year.
What is ACA Open Enrollment?
First, open enrollment is the yearly opportunity to obtain health insurance plans that comply with the Affordable Care Act (ACA). This window of opportunity generally opens on November 1 and closes on January 15 of each year.
What Are the Consequences of Missing Open Enrollment
There are three main consequences if you have missed ACA open enrollment:
First, if you were enrolled in an ACA-approved plan last year, that plan may have automatically renewed. You might be stuck with a plan that no longer fits your needs or budget. If you cancel your ACA-approved plan after the auto-renewal, the following two consequences may be the result.
Second, you may miss out on premium tax credits and other subsidies to make health insurance more affordable for you and your family.
Third, you may be facing the next year with no health insurance. This situation could expose you to significant financial risk if you experience a sudden illness or injury or require emergency medical treatment. Without health insurance, you’ll be accountable for these bills, which can rapidly become overwhelming.
What can you do to avoid getting stuck in the third category?
Available Options if You Have Missed ACA Open Enrollment?
Fortunately, you do not have to face the coming year without health insurance, even if you have missed ACA open enrollment. Here are a few avenues that are open to you.
Do You Qualify for a Special Enrollment Period?
Knowing that circumstances change during the year, the ACA determined that certain situations may require changing healthcare needs. Therefore, the first option to explore when you have missed ACA open enrollment is to see if your circumstances qualify you for a special enrollment period. Do any of these life changes apply to you?
Changes in your household, including marriage, dissolution of marriage, birth or adoption, or death of a member of the household insured on the ACA plan.
Changes to your residence, such as moving to a new zip code, county, or state or if you have moved into transitional housing or a shelter.
You have lost previous health care coverage due to losing your or a spouse’s job, AHCCCS benefits, or Medicare Part A (through no action or inaction of your own).
For a more comprehensive list and explanations of qualifying circumstances, click here.
Do You Qualify for Arizona’s Medicaid Program?
Arizonans who meet the household and income requirements may be eligible for enrollment in Arizona’s Medicaid program, the Arizona Health Care Cost Containment System (AHCCCS), or the KidsCare program.
To see if you qualify for these benefits, contact AHCCCS directly.
If you previously enrolled in ACHHHS but are losing Medicaid benefits due to the nationwide Medicaid Rewind initiative, an independent health insurance broker can help.
Learn More: Where Can Arizonans Find Cheap Health Insurance Plans After Losing AHCCCS?
Short-Term Health Insurance Plans
If your circumstances do not qualify you for a special enrollment period, or you do not meet the household and income requirements for AHCCCS, other options are still available. One popular choice for those who have missed ACA open enrollment is to enroll in a short-term health insurance plan in Arizona.
These temporary plans are designed to fill the gap while you are without health insurance and can last from 30 days to a year (or more, depending on the plan). Short-term health insurance plans have several advantages for those who have missed ACA open enrollment. As with any healthcare plan, temporary insurance policies have advantages and disadvantages. Here are a few.
Advantages
Healthcare coverage typically starts immediately, with no waiting period.
Essential healthcare needs, such as doctor visits and hospital stays, are provided for in case of an unforeseen injury or sudden illness.
Short-term health insurance plans may be more cost-effective for some individuals and families due to potential limitations in coverage.
Disadvantages
Insurance companies that provide short-term health insurance plans are not required to provide the same minimal level of coverage as ACA plans.
The lower costs associated with temporary plans often mean pre-existing conditions and preventative care are not covered.
Remember, short-term health insurance plans are just that – short-term. These plans are not designed to solve Arizonans’ health insurance needs permanently. Instead, they are a way to bridge the gap until you find a permanent solution.
Related Understanding Temporary Health Insurance in Arizona
Private Health Insurance Plans
Enrolling in a private health insurance plan is another option if you have missed ACA open enrollment this year. Here are some advantages and disadvantages of getting health insurance outside the federally approved Exchange.
Advantages
There are no open enrollment limitations – you can obtain coverage for yourself or your family anytime during the year.
There are no income restrictions for individuals or families applying for coverage.
Because these plans are not subject to ACA guidelines, the policies may have more variation in terms of benefits and cost-sharing options.
Disadvantages
Health insurance plans obtained outside of the Exchange may have limitations based on pre-existing conditions.
Your plan may not cover preventative care and essential services such as maternity care or prescription drug coverage.
There may be annual or lifetime caps on what the insurance will pay for specific treatments.
Of course, there are various factors to consider before enrolling in any health insurance plan. These include monthly premiums, out-of-pocket costs, and network availability.
How Can A Broker Help if You Missed ACA Open Enrollment?
If you missed ACA open enrollment this year, the first thing you should do is contact a local independent health insurance broker. Why do we say that?
Because health insurance brokers have the knowledge, experience, and resources you need. These experts live and breathe the insurance industry and can present you with options for health coverage that you may have never known were available. They will take the time to get to know you and your circumstances and can present plans for your consideration from a variety of insurance companies with various benefits – ensuring you get the right plan at the right price. And the best part about it is that you can take advantage of their experience and resources without paying a dime for their services.
With an independent health insurance broker, your health insurance needs are the priority.
Arizona Health Insurance Experts is proud to connect you to an independent health insurance broker right in your neighborhood – free of charge. Why not get started today?
