Tag Archives: Qualified Health Plan

SEP Changes like Moving

When Change Happens, We Can Help

Things change. We understand that the unexpected is a part of life. But there are ways we can help you get covered when the unexpected happens.

If you weren’t able to get coverage during this Annual Enrollment Period, or if something important has changed and you need a new plan, you may be able to get a Special Enrollment Period (SEP).

During an SEP, you can buy a new plan or make changes to your current plan.

To get an SEP, you need a qualifying life event (something that has changed your insurance needs). Qualifying life events include:

  • Getting Married
  • Having, adopting, or the placement of a child
  • Permanently moving to a new area offering different health plan options
  • A change in income or household status, which can change how much government help you can get
  • Losing other health coverage because of:
    • Job loss
    • Divorce
    • Loss of eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
    • Expiration of COBRA coverage
    • Your health plan no longer meets the requirements of the Affordable Care Act (ACA)
    • Reduction or termination of employer contributions
    • Significant increase in the cost of your plan

If any of these items describes your situation, you have 60 days after that event to enroll in a new plan. You can shop with us online or call us at 1-877-686-1168 for help finding a plan.

Your new coverage date will depend on the kind of life event you had and what day of the month you enroll. Learn more about when your new plan will start.

Losing your coverage doesn’t always mean you get an SEP. You can’t get one if you lose your insurance because:

    • You didn’t pay your premiums
    • You chose on your own to quit your other health coverage
    • You lost a short-term plan or (in some cases) a Catastrophic plan

If you can’t get an SEP, you can always get covered with a short-term plan at any time. While they do help with your health costs, they aren’t qualified health plans under the ACA, which means you could still have to pay a tax penalty in the next year.

Still not sure what to do in your situation? Call us at 1-877-686-1168 for help figuring out your options.

Shop Online for Health Insurance

New to Shopping for Health Insurance?

If you’ve never shopped for health insurance before, it can be a little scary. We are going to make the journey easier this Open Enrollment Period. Check back each week for another post that helps you shop for a Health Alliance plan.

We’ll start small – with the Open Enrollment Period.

The Open Enrollment Period (OEP) is from November 15 to February 15 this year. Each fall, the government picks a time that you can buy insurance for the next year.

What happens if you don’t enroll by February 15?

You will have to wait until the next Open Enrollment Period (fall of 2016), or have a life-changing event, like getting married or having a baby, that qualifies you for a Special Enrollment Period.

After February 15, most people will have to pay a penalty for not having a plan, and worse yet, they’ll still have to pay for 100%of their medical costs. Talk about adding insult to injury!

Can you change your plan after the OEP?

No, you would have to wait until the 2016 OEP to change plans. If you’re unhappy with your current plan, now is the time to take action!

How does the government know if you have insurance?

They’ll ask you on your taxes. Health insurance companies like Health Alliance will also turn in information to the IRS telling them who has a qualified health plan (QHP) through us.

What’s a Qualified Health Plan?

A Qualified Health Plan (QHP) is a plan that is certified by the federal Health Insurance Marketplace. That means it will include all the benefits the Affordable Care Act (ACA) requires and meets all of the spending limits and rules of the ACA.

Why should you buy health insurance instead of paying the fine?

Sometimes, especially when you’re young and healthy, it seems like paying a one-time fine could be a better deal than paying a monthly insurance premium.

But in that case, you need to weigh the risk with the money. The average hospital stay for people 18 to 44 years old is $7,400.

The average cost of a broken arm for a simple break is $2,500-$3,500. If it was bad break, it can be several times more than that.

Can you afford to pay $2,000 out-of-pocket? What about $10,000? What if you were in an accident or needed surgery, would the cost of taking care of yourself ruin you financially? When you think about it that way, the cost of health insurance is a good investment. Learn more about insurance on our website.

When you’re ready to start shopping, Health Alliance can help you. Visit HealthAlliance.org or call us at 1-877-686-1168 to learn more.