Individual and Family Plans
The Affordable Care Act changed the way insurance companies handle eligibility in the individual and family health insurance market in Oregon and Washington. In the past, entry into an individual policy required that you receive approval to be accepted into a health insurance policy, and this was done by completing a health statement form. That is no longer the case. All individuals are now accepted, no matter the condition of your health, but only during an active open enrollment period.
Beginning November 1st, you may shop for a new policy that will become effective on January 1, 2019. Open enrollment for a January 1st effective date, closes on December 15, 2018. It’s important to know that if you’re seeking coverage for a January effective date through your state’s insurance exchange via the marketplace, you must enroll by the 15th of the month prior to your desired start date. If you’re shopping direct through an insurance company, you may have a few extra days to submit an enrollment application, based on the insurance company’s specific guidelines.
Enrollment into a new plan may also occur outside the open enrollment period, but only if you’ve experienced a new qualifying event. What is considered a new qualifying event? Marriage, the birth of your baby, the loss of coverage through your employer, or a dependent turning age 26, are all examples of life circumstances that allow you to enroll in a new plan, 1st of the month following the qualifying event.
For various reasons you may find yourself without coverage and desire to fill the gap with a Short Term Medical policy. Although this type of policy does not cover pre-existing conditions and it’s not compliant under the new Affordable Care Act, it is a temporary and very affordable solution. It brings peace of mind knowing that you are covered should you experience a new illness or injury. We can help connect you with this type of plan.
If you have any questions about individual and family policies, we are ready and willing to help assist and guide you to an option that will meet your needs!