Special Qualifying Events for People Who Still Don’t Have Health Insurance

Fran Majidi
February 1, 2019

If you didn’t enroll in a health plan this year, you may think that you’re stuck with a hefty fine come tax season next year. It’s never fun getting penalized, and a fine may seem insurmountable to you right now. On top of the financial stress of it all, you’re uninsured so that if something did happen to you or if you got sick, you’d be in an even bigger hole. The good news is that it may not be too late to get health insurance. The better news is that beginning in 2019, there is no penalty for having no health insurance. Yes, you heard correctly: no fine for having no health insurance in 2019. Only time will tell how the eradication of the individual mandate will affect the Affordable Care Act (ACA) but many Americans feel relieved that they won’t get hit hard next tax year. Let’s look at the fines in 2017 and 2018: $695 per adult and $347.50 per child, with a maximum fine of $2085 per household or 2.5 percent of the total household income, whichever was greater.

While there are no fines this year, certainly, money shouldn’t be the only factor you consider when looking at the big picture. You don’t want to be uninsured if you are involved in an auto accident that requires medical attention (possibly hospitalization) or get really sick unexpectedly and have zero insurance. If you already have a chronic condition, it’s important that you continue seeing your doctor(s). There’s more good news: thousands of uninsured Americans who missed open enrollment earlier in January can still enroll in a health plan based on “special qualifying events.” If you fall in this category, that means you can still get insured! It’s estimated that between 8 and 10 million Americans are eligible for special qualifying events despite missing the open enrollment deadline. If you want to compare rates instantly, visit here.

Here are some of the more common reasons you may qualify for enrolling in a healthcare plan late in the game:

  • Lost or quit job. You may have lost a job, changed jobs or even started your own business. If you lost a job and with it your health insurance, you qualify for the special enrollment period. If you changed jobs and are not offered health insurance, you qualify to buy health insurance after the enrollment period.
  • Turned 26. If you were on your parents’ health insurance plan but turned 26 after the enrollment period, you can enroll in an individual health plan.
  • Moved to another state or out of an HMO coverage area. You may have had a health plan that was only valid in one state but you moved to another state after the enrollment period. You can sign up for a new health plan. 
  • Cobra coverage ended. If you extended your healthcare with Cobra and reached the deadline, you can enroll in a new health plan.
  • Divorce. If you were married and shared a health plan coverage with your spouse but divorced, you still have time to enroll in a new health plan for 2019.
  • Marriage. If you recently married, you may be able to get added onto your spouse’s policy or start an entirely new one together.
  • Birth or adoption of a child. If your baby was born or brought home after the open enrollment date, you can still buy health insurance for that child.
  • Death of spouse or partner. If you were covered under your spouse or partner’s health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
  • Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

If you’re looking for an agent to set you up with a plan that fits specific needs and a budget, contact us so we can put you in touch with a reliable agent: (855) 214-2291

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