Now that Open Enrollment is over, how can I obtain Medical Insurance?

The Affordable Healthcare Act (ACA) has changed the way Health Insurance Coverage can be obtained. Medical Insurance must be applied for during the Annual Open Enrollment period that last from November 1 – December 15. If it is not the Annual Open Enrollment period you can only enroll into a Qualified Medical Insurance plan if you have a Qualifying Life Event.

Qualifying Life Events typically are the result of an involuntary loss of coverage within the last 60 days. Examples of qualifying events are :

    1. Loss of Group Medical Insurance due to employment termination or change
    2. Change in marital status as result of marriage, divorce, death.
    3. Loss of medical coverage due to event that qualifies for COBRA
    4. Changes in family / number of dependents
    5. Plan no longer available as result or relocation

If it is not Open Enrollment or you do not have a Qualifying Life Event you cannot enroll into a Qualified Medical Insurance Plan.

The reason is because of Pre-existing Conditions, since qualified plans cannot exclude or restrict coverage because of a pre-existing condition they only allow you to enroll at the beginning of the year (otherwise you could become ill or injured today, get a policy, and the policy would be required to pay your medical bills). Insurance is designed such that you pay when you don’t need it so it is there when you do.

An Alternative to Qualified Medical Insurance

There are Non-Qualified Programs that are available all year long, (Medical Sharing Programs), these programs have restrictions on Pre-Existing conditions. These plans will pay for any new conditions that arise after the effective date but will not pay for conditions that exist prior to effective date. Because these programs restrict pre-existing conditions rates are 30 – 50% less than Qualified Medical Insurance plans. I was able to reduce my rates from in excess of $650/mth to $350/mth with less financial exposure.

Please review these blog posts that provide details regarding Medical Sharing Programs.

December 2018

November 2018

Are you a Small Business Owner?

Did you know as a business, you can enroll into a Qualified Plan at any time during the year. You require a minimum of 1 W-2 employee or 2 employees. There are better plan options available to Businesses, plans with Lower Deductible’s, Out of Pocket Maximum’s & plans that offer access to more doctors.