Open Enrollment Is Over. Here's What to Do if You Still Don't Have Health Insurance

The annual open enrollment period for health insurance ended as of Jan. 16, 2024. But open enrollment is not your only chance to get health insurance. If you've had a job change, or if you or someone in your family has had other big changes in their life or income, you can get health insurance outside of open enrollment.

If you don't have health insurance, or if your company is going through layoffs and you're worried about what happens next, rest assured that you still might have options to get health coverage for 2024. Let's look at a few ways that you can get health insurance outside of open enrollment.

1. Use COBRA coverage (if you can afford it)

If you lose or quit your job in 2024, you might be able to keep using your employer-based health insurance by paying for COBRA coverage. However, COBRA premiums are often much more expensive than the amount you paid while employed full-time -- you have to pay for your employer's share of the premium as well as your own.

COBRA insurance is not the best long-term solution for everyone. But it can give you some short-term flexibility and peace of mind while you find your next job, next health insurance plan, or other options. For example, if you want to keep getting healthcare from a certain doctor or clinic that is in-network and covered by your old job's health insurance, COBRA can be a good choice. It might be worth paying extra for COBRA premiums to keep getting the same coverage with the same provider network that you're used to.

But if you don't have special medical needs, don't want to keep your old job's health insurance plan, or can't afford (or don't want to pay) the high costs of COBRA premiums, you should try the next option on this list: a Special Enrollment Period.

2. Try to get a Special Enrollment Period on HealthCare.gov

Leaving a job is one of the most common reasons why people might need to find new health insurance. If you get laid off, quit your job to start a small business, become a full-time caregiver for children or other loved ones, or pursue early retirement, you might need to choose a new health insurance plan. Fortunately, you have options.

On HealthCare.gov, there is a special rule for health insurance sign-ups called a "Special Enrollment Period." This gives you the right to choose a new health insurance plan any time of year -- but only if you have a qualifying life event (QLE). QLEs are certain big life changes to your income, family, or household that cause you to lose your coverage or re-evaluate your insurance.

Here are a few qualifying life events that can enable you to get a Special Enrollment Period on HealthCare.gov:

• Losing job-based health insurance coverage
• Significant decrease in household income
• Changes in household (such as getting married, getting divorced and losing your coverage, or welcoming a new baby or adopted/foster child)
• Moving to a new home (in a new ZIP code or county)
• Loss of eligibility for some government insurance programs like Medicaid, state Children's Health Insurance Program (CHIP) or premium-free Medicare Part A

Some of these changes can be retroactive to the past 60 days. So if you've recently had a big change in your family, your home, or your job, check with HealthCare.gov to see if you can get a Special Enrollment Period to enroll in a new health insurance plan (or change your current plan).

3. Consider short-term health insurance (but beware of the limitations)

If you somehow don't qualify for a Special Enrollment Period, missed the deadline, or otherwise are in some special circumstances that prevent you from getting health insurance, you have one other option: short-term health insurance.

This is a type of insurance that does not cover all of the same care, or follow all of the same rules, as the plans on HealthCare.gov. Insurance premiums on HealthCare.gov are not always cheap (although you can get premium tax credits based on your income), but the plans are all required to meet the standards of the Affordable Care Act (ACA). Being an "ACA-compliant" plan means the insurance company is required to cover you for a wide range of conditions and treatments, with no exclusions for pre-existing conditions.

Short-term health insurance plans don't work like that. The plans might be offered by some of the same insurance companies you'd see on HealthCare.gov, but short-term plans don't have to comply with ACA standards. Your premium might be lower with a short-term plan, but the coverage is less.

For example, many short-term health insurance plans might not cover:

• Pre-existing conditions
• Maternity care
• Mental health care
• Highly expensive treatments (there are "lifetime limits" on the amount of coverage you can get with a short-term plan)

If you're young, generally in good health, and have no other options, short-term health insurance can be better than taking the risk of going uninsured. These plans do cover some types of care, and could be a decent choice to tide you over until you find your next job or can get covered by a HealthCare.gov plan.

Bottom line

If you don't have health insurance, you still have options to get covered outside of annual open enrollment. Start by going to HealthCare.gov and seeing if you can get a Special Enrollment Period based on recent changes in your life. If you can't get a HealthCare.gov plan, you might consider short-term health insurance as a last resort.