Missing the open enrollment deadline can be stressful, but you still have options to get covered.
Whether you forgot the deadline, changed jobs, or simply didn’t sign up in time, you don’t have to wait an entire year to secure health coverage.
There are multiple ways to get insured even after open enrollment ends, from Special Enrollment Periods to health sharing plans and short-term coverage.
Understanding these options can help you make an informed decision and find a plan that works for your needs and budget.
Wondering how to get health insurance after open enrollment? Here are the best alternatives to stay protected and avoid high costs.
What Happens If You Miss Open Enrollment?
The Open Enrollment Period (OEP) is the designated time each year when individuals can sign up for health insurance through the Affordable Care Act (ACA) marketplace.
This period typically runs from November 1 to January 15. If you miss this deadline, you generally cannot enroll in an ACA plan unless you qualify for a Special Enrollment Period (SEP).
How to Get Health Insurance After Open Enrollment?
1. Special Enrollment Periods (SEPs)
A Special Enrollment Period allows you to get health insurance outside of the standard enrollment window.
Life events such as losing job-based coverage, getting married, having a baby, or moving to a new coverage area may qualify you for an SEP.
You have 60 days from the qualifying event to enroll in a new plan. Proof of the qualifying event is required, so be prepared to provide documentation.
2. Employer-Sponsored Health Plans Outside Open Enrollment
If your employer offers health insurance outside ACA open enrollment, you may qualify for an employer-sponsored plan, especially if you started a new job.
Many companies allow new employees to enroll in coverage immediately or during a designated enrollment window. Check with your HR department to see if you qualify.
3. COBRA Coverage for Job Loss
If you lost employer-sponsored health insurance, COBRA allows you to continue your existing coverage.
This option is usually available for up to 18 months. While COBRA ensures uninterrupted coverage, premiums can be expensive because you’ll pay the full cost of the plan.
4. Medicaid and CHIP: Government-Sponsored Coverage
If your income falls below a certain level, you may qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
Unlike ACA plans, Medicaid enrollment is open year-round. Eligibility requirements vary by state, so check with your local Medicaid office to see if you qualify.
5. Health Sharing Plans: An Affordable Alternative
Health sharing plans provide a cost-sharing approach to medical expenses.
These are nonprofit programs where members contribute monthly and share healthcare costs. Many participants save 40%–50% compared to traditional insurance.
Popular health sharing plans include:
These plans do not qualify for ACA subsidies and may have restrictions on pre-existing conditions. However, they can be a viable alternative for individuals seeking affordable healthcare coverage.
6. Short-Term Health Insurance Plans
Short-term health insurance provides temporary coverage until the next open enrollment period.
These plans typically last from 30 days to 12 months, depending on state regulations. They can be a good option if you’re between jobs or waiting for an SEP qualification.
However, short-term plans may not cover pre-existing conditions and often have limited benefits. Be sure to read the policy details carefully before enrolling.
7. Catastrophic Health Insurance Plans
Catastrophic health insurance plans are designed for individuals under 30 or those who qualify for a hardship exemption.
These plans have low monthly premiums and high deductibles, providing protection against worst-case scenarios. They cover essential health benefits, including preventive services, and at least three primary care visits per year before you’ve met your deductible.
However, they may not be suitable for those who require regular medical care due to the high out-of-pocket costs before coverage kicks in.
8. Direct Primary Care (DPC) Memberships
Direct Primary Care (DPC) is a healthcare model where patients pay a flat monthly fee to a physician or medical practice for unlimited access to primary care services.
This model eliminates the need for insurance billing, providing a more straightforward and personal healthcare experience. DPC memberships typically range from $50 to $150 per month and cover services like routine check-ups, preventive care, and basic lab work.
DPC does not cover specialist visits or hospitalizations, so it’s often paired with a high-deductible health plan or catastrophic insurance to provide comprehensive coverage.
Choosing the Best Health Coverage After Open Enrollment
If you missed open enrollment, take time to evaluate your options. Consider the following factors when selecting a plan:
- Do you qualify for a Special Enrollment Period?
- Would a health sharing plan work for your needs?
- Is short-term health insurance a suitable bridge until open enrollment?
- Are you eligible for Medicaid or CHIP?
- Does COBRA fit within your budget?
- Are catastrophic health insurance plans appropriate for your situation?
- Would a Direct Primary Care membership meet your primary healthcare needs?
Take Action Now
Don’t wait until it’s too late to secure health coverage.
Missing open enrollment doesn’t mean you have to go without insurance. Whether you qualify for a Special Enrollment Period, need an affordable health-sharing plan, or want short-term insurance to bridge the gap, there are still plenty of options available.
If you’re not sure which option is best for you, professional guidance can make the process easier. HSA for America specializes in helping you find the right health coverage solutions tailored to their unique needs.
Schedule a Free Consultation with a Personal Benefits Manager today and get the support you need to make an informed decision about your healthcare coverage.
For Further Reading:
Compare Pricing on the Best HealthShare Plans Available
FAQs About Open Enrollment
What happens if I miss the open enrollment period for health insurance?
If you don’t sign up for health insurance during the open enrollment window, you’ll likely have to wait until the next enrollment period unless you qualify for a Special Enrollment Period (SEP). Other options include short-term plans, health-sharing programs, and Medicaid if you’re eligible.
Can I enroll in health insurance at any time if I have a major life change?
Yes, certain life events like getting married, having a baby, losing job-based coverage, or moving to a new state can trigger a Special Enrollment Period, allowing you to get insurance outside the usual enrollment period.
Does open enrollment apply to all types of health insurance?
No, open enrollment mainly applies to ACA marketplace plans and employer-sponsored insurance. Medicaid, CHIP, short-term health plans, and some health-sharing programs accept new members year-round.
Are there penalties for not having health insurance if I miss open enrollment?
The federal penalty for being uninsured was removed, but some states still impose fines for not having health coverage. It’s best to check your state’s regulations to see if a penalty applies.
Can I switch my health insurance plan after open enrollment ends?
Only if you qualify for an SEP. Otherwise, you’ll need to wait for the next open enrollment period or explore alternative options like short-term coverage.
What are my options if my employer doesn’t offer health insurance and I missed open enrollment?
If your job doesn’t provide coverage and you missed the ACA enrollment deadline, you can look into Medicaid (if eligible), health-sharing plans, or short-term insurance until the next open enrollment.
Wiley is President of HSA for America. He believes that consumers should have choice and price transparency, so they can make the best healthcare decisions for their needs. Read more about Wiley on his Bio page.
