Individual

What to do if you missed the open enrollment deadline

by Amy

The deadline for signing up for health coverage for 2020 was December 15th in most states. If you didn't make the deadline, don't worry. You've got a few options (and you might have more time to sign up.)

The individual mandate may have been repealed, but that doesn't mean you should skip coverage. Trust us on that one. 

If you missed the open enrollment deadline, there’s a chance you have a bit more time. If you don't qualify for more time, you have a few options. 

Let's jump in and get you covered. 

Time (might be) on your side

You might have more time if:

  • You live in Connecticut, Rhode Island, Colorado, Minnesota, Washington, Massachusetts, D.C., California or New York. These states have extended their deadlines anywhere from one to six weeks.
  • You are a Native American or eligible for Medicaid / CHIP (you can enroll any time if this is the case).
  • You have a life qualifying event (more on what this means below)

Qualifying life events & special enrollment periods 

If you missed the deadline for selecting your new healthcare coverage for 2020, you may still be in luck. You can enroll as late as December 31st, 2017 for a Health Insurance Marketplace plan if you have any of the following eligible life events. Even though an enrollment period starts 60 days following the day of the event, in most cases you can enroll up to 60 days before the event. This allows your coverage to start on the day of the event and allows people to avoid any gaps in coverage. 

The following events trigger a special enrollment period: 

Changes in household

You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

  • Got married.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Death. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and you’re no longer eligible for your current health plan as a result of their death.

Changes in residence

  • Household moves that qualify you for a Special Enrollment Period:
  • Moving to a new home in a new ZIP code or county
  • Moving to the U.S. from a foreign country or United States territory
  • A student moving to or from the place they attend school
  • A seasonal worker moving to or from the place they both live and work
  • Moving to or from a shelter or other transitional housing. You must prove you had health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.

Loss of health insurance

  • If you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
  • Losing job-based coverage
  • Losing individual health coverage for a plan or policy you bought yourself. There are several carriers leaving certain states or the entire individual market altogether.
  • Losing eligibility for Medicaid or CHIP
  • Losing eligibility for Medicare
  • Losing coverage through a family member

Additional qualifying changes

  • Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Leaving incarceration
  • AmeriCorps VISTA members starting or ending their service

Being offered an ICHRA or QSEHRA from your employer

If your employer opts for an affordable, more efficient alternative to a traditional group plan, like the Qualified Small Employer HRA (QSEHRA or the Individual Coverage HRA (ICHRA), you have 60 days to find coverage from the effective date of the HRA. An HRA can be offered any time of the year. 


If you don’t qualify for an extension, here’s what to do.

If you missed the open enrollment deadline, don’t live in a state with an extended open enrollment period, and aren’t expecting a life qualifying event, your options for 2020 coverage are limited to policies not regulated by the ACA. 

An important thing to remember here is that these plans aren't necessarily compatible with an HRA from your employer for reimbursement. It's important to check first if you fall into this category. 

These include:

  • Pivot: We offer short-term insurance solutions through Pivot to cover you until a qualified major medical health plan is chosen, helping reduce your financial risk. Pivot plans are renewable 90 day plans which in most states can be automatically renewed four times without additional medical screening to provide up to 12 months of continuous coverage. While the maximum time might change in the coming months due to policy changes, for now it means you have an entire year of coverage. Short-term plans are very affordable but have certain restrictions and exclusions you should be aware of (it doesn’t cover pre-existing conditions or preventative care). 
  • Medi-Share: you can sign up for a faith-based plan any time. Medi-Share is available in all 50 states and it's managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It has a legit PPO network that provides flexibility to see your doctors and it covers out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.
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How Can Take Command Health Help?

Please visit our website and we'll walk you through your options, even if you missed the open enrollment deadline. Our goal is to help you get the most out of your money and find the plan that really works for you and your family.

We also have a premier membership that you can sign up for any time, including some pretty awesome deals for our members. Call a doctor 24/7 for $0, medical bill negotiation support, dental, vision, and pharmacy discounts, etc. In addition to saving stress and time spent in waiting rooms, the Take Command Health membership plan helps those dollars spent on healthcare stretch further. 

Ready to start? You can chat with us on our website or email us at support@takecommandhealth.com

Picture of Amy

Hi, I'm Amy! I wrote this blog because I care about ideas (big and little) that can help fix our healthcare system. I used to work on projects for Kaiser Permanente and the Parkland Health & Hospital System so I've seen the system inside and out. It's so important that consumers keep up with industry shifts and changing health insurance regulations. I'm also Take Command Health's Content Editor and a busy mom. Learn more about me and connect with me on our about us page. Thanks!