Page 21 - Leisure Living Magazine: Autumn 2020 Edition

Can I Enroll In Health Insurance Coverage At Any Time?
“Law You Can Use” By Douglas Anderson, Squire Patton Boggs, LLP Courtesy of the Ohio State Bar Association
It is almost November, which marks the beginning of the annual open enrollment period for health insurance. As this time approaches, it is important to realize that if you want to buy coverage from a health insurance compa- ny directly, or if you have coverage through an employer, you can only enroll in health insur- ance coverage during this time. That is, unless there is a “qualifying event” in your life, in which case, you can enroll at other times of the year.
Qualifying events
“Qualifying events” are life changes that impact your health insurance coverage. If you experience a qualifying event, you can enroll in health insurance coverage outside of the open enrollment period. A qualifying event could be if:
• you are covered by an employer policy and then lose coverage because you quit, you are fired, or you experience a reduction in working hours;
• you get divorced or lose a spouse or a parent;
• you become entitled to Social Security ben-
efits;
• you were a dependent child, but have become
too old to stay on a parent’s plan;
• you gain citizenship;
• you are released from incarceration;
• you gain status as a member of a Native
American tribe;
• you move outside of your current insurer’s
coverage area;
• you have a change in income or household
status that affects your eligibility for federal health insurance subsidies or cost-sharing reductions;
• you lose coverage because your employer goes bankrupt.
Marriage or the birth or adoption of a child can also be qualifying events, allowing you to add a new spouse or child to an existing plan. Additionally, if you qualify for Medicaid (gen- erally available to individuals and families with incomes of less than 138 percent of the feder-
www.LeisureLivingMagazine.com
November is the beginning of Open Enrollment.
al poverty limit), you can apply for Medicaid without restrictions at any time of the year. It is important to understand that if you have enrolled in an insurance plan through the federal health insurance Marketplace (www.healthcare.gov), voluntarily quitting a Marketplace plan in the middle of the year is not a qualifying event and you may be unable to enroll in another plan until the next annual open enrollment period.
Open enrollment period
Under state and federal law, insurers are required to offer coverage to anyone who applies only during open enrollment periods, except when a qualifying event requires an insurer to offer coverage outside of an open enrollment period. If you want to buy coverage directly from an insurance company without an employer being involved, the annual open enrollment period for coverage that will become effective on January 1, runs from Nov. 1 to Dec. 15. If you don’t enroll in coverage during this period, you may have to wait until next year’s open enrollment period, unless you have a qualifying life event.
When you are first hired by an employer, you may be able to enroll in employer coverage immediately or you may have a waiting period of up to 90 days. If you do not enroll at your first opportunity, you may have to wait until your
Continued on page 22
Autumn 2020 LeisureLiving | 21