When You Can’t Enroll In Obamacare, You May Still Have Coverage Options
One of the questions we are asked most often at Preferred Insurance is if it is possible to purchase individual or family health insurance that is not Obamacare.
While it is true that many Californians buy individual health insurance through the Covered California Marketplace, the Golden State’s centerpiece of the Affordable Care Act, there are many people who wonder if they are able to get health care coverage outside of the Marketplace.
The question is an extremely important one for individuals and families who don’t get group health insurance coverage through their California employer. That’s because you can’t enroll in an Obamacare plan whenever you want. If you need health insurance after the Open Enrollment period ends and you don’t qualify for a Special Enrollment Period, health insurance that isn’t Obamacare may be your only coverage option.
Here is what you need to know if you need to buy health insurance that is not Obamacare:
Why You Might Need a Non-Obamacare Plan
As noted, the primary reason many people look outside of the Marketplace for health insurance that is not Obamacare is that the window to obtain Obamacare coverage has closed or they have not recently experienced a qualifying life event that allows for immediate enrollment.
Each year, there is an Open Enrollment period during which individuals can shop for and enroll in health plans through the Marketplace. Most years, that period comes near the end of the calendar year, as it does this year for 2022 plans. But due to the COVID-19 pandemic, the federal government mandated an additional Open Enrollment period that began on February 15, 2021, and ended on August 15, 2021. The next window for Open Enrollment does not begin until November 1, 2021, and lasts through December 15, 2021.
This means individuals will not be able to enroll in or modify an Obamacare plan until November 2021, unless they qualify for a Special Enrollment Period, designated by a “qualifying life event”. Such events include:
- Birth, adoption, death of a named insured, marriage, or divorce;
- Loss of existing coverage due to job loss, disqualification from Medicare or Medicaid, or aging out of coverage under a parent’s plan;
- Becoming a U.S. citizen or release from incarceration; or
- Moving to an area outside of your existing insurer’s coverage.
What Is Health Insurance That Is Not Obamacare?
You won’t find health insurance that is not Obamacare on the Marketplace. Insurance companies sell private health plans in which you can enroll at any time, either directly or through licensed independent brokers, insurance agents, or online health insurance sellers.
These plans, sometimes called short-term health insurance, do not necessarily meet all of the requirements of the ACA. Though these plans may be more affordable than Affordable Care Act qualifying plans, the benefits are almost always less comprehensive. That means many of the features we’ve come to associate with Obamacare – such as coverage for pre-existing conditions, preventative care, and mental health coverage – may not be part of a plan.
If you enroll in a health plan outside the Marketplace, whether during Open Enrollment or not, you can’t receive premium tax credits or other savings based on your income that are available for coverage purchased through the Marketplace. These tax credits and subsidies are what make quality healthcare plans available to many people who could not otherwise afford coverage.
Who Can Help Me Obtain Health Insurance That Is Not Obamacare?
Since the initial implementation of Obamacare over a decade ago, the health insurance needs of Californians have changed dramatically, and health insurance is often as confusing as it is essential. Even the smartest and most shrewd individuals can struggle to understand the nuances of all the available plans or determine which option is best for their healthcare needs and budget. This can be especially true for individuals who need coverage immediately and can’t enroll in an Obamacare plan until a later date.
If you need help today to find health insurance that is not Obamacare, the good news is that you don’t need to do it on your own.
As an experienced California small business and individual health insurance broker, Preferred Insurance can answer your questions and provide practical, affordable solutions for your insurance needs. We will always have your best interests at heart and deliver the personal service and expert guidance you need.
Contact Preferred Insurance today to arrange for your free consultation to discuss your small business or individual health insurance needs.