Experient Health Explains Open Enrollment Under Health Care Reform In Latest Blog Post

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After open enrollment, individuals can enroll in a private health plan if they have a qualifying life event or a complex situation related to applying for health care coverage.

A top question Experient Health benefits consultants face in the new era of health care reform by individuals and families is if and when they can get coverage outside of the government's open enrollment period.

Experient Health, the health insurance arm of the Virginia Farm Bureau, took on this question in its latest blog post. Experient Health launched its blog last year to help educate the community on health care reform and healthy living, a hallmark of preventative medicine.

As Experient Health explained, the initial open enrollment period for the Marketplace, the government's mechanism to purchase health insurance, began on Oct. 1, 2013 for coverage starting as early as Jan. 1, 2014.

The Marketplace initial open enrollment period ended on March 31, 2014.

"After open enrollment, you can enroll in a private health plan through an Exchange only if you have a qualifying life event or a complex situation related to applying for coverage in the Exchange," Experient Health wrote. "You can apply for Medicaid and the Children’s Health Insurance Program (CHIP) at any time during the year. If you qualify, you can enroll immediately."

Examples of life events include the following:

  •      Marriage or divorce
  •      Having a baby, adopting a child or placing a child for adoption or foster care
  •      Moving your residence, gaining citizenship, leaving incarceration
  •      Losing other health coverage—due to losing job-based coverage, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances.

"Voluntarily ending coverage doesn’t qualify you for a special enrollment period," Experient Health wrote. "Neither does losing coverage that doesn’t qualify as minimum essential coverage."

The community's next chance to enroll in health coverage through the Exchange is the next open enrollment period, scheduled for Nov. 15, 2014 to Feb. 15, 2015. Coverage can start as soon as Jan. 1, 2015.

Experient Health benefits consultants are available for more information about open enrollment, understanding qualifying events and helping families and individuals with the Marketplace.

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Stephanie Heinatz
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