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Small Business Employee Benefits and HR Blog

FAQ - When Can I Buy an Individual Health Plan?

When can i buy an individual plan?Individual health plans are now more accessible and affordable. As such, it is more and more common for small business owners, their families, and their employees to be covered under an individual health plan. Under new health reform ("Obamacare") rules, however, there are limited windows when you can purchase guaranteed-issue coverage.

In this article, we answer the frequently asked question, “When can I buy an individual health plan?” 

When Can I Buy an Individual Health Plan?

As of 2014, there are two windows of time (“enrollment periods”) when you can purchase an individual health plan: 1) during the annual open enrollment period, or 2) during a special enrollment period.

Annual Open Enrollment Period

As the chart below shows, the annual enrollment period for coverage in 2016 begins November 1, 2015 and extends through January 31, 2016. During this time, anyone can purchase a health plan on the individual market, or change plans.

COVERAGE YEAR

ANNUAL OPEN ENROLLMENT PERIOD

2016

November 1, 2015 - January 31, 2016

2017

October 15, 2016 - December 7, 2016

2018

October 15, 2017 - December 7, 2017

2019

October 15, 2018 - December 7, 2018

2020

October 15, 2019 - December 7, 2019

Note - Dates are subject to change. Dates are accurate as of 9/15/2015.

If you fail to purchase health insurance coverage during the annual enrollment period, you will be unable to purchase coverage until the following year unless you qualify for a special enrollment period.

Special Enrollment Period

A special enrollment period is a time when you’re allowed to make changes to your health insurance plan, even though it is not an open enrollment period.

To qualify for a special enrollment period, you need to have a qualifying life event (aka a “triggering event”). Life events that may qualify you for a special enrollment period include:

  • Getting married

  • Having a baby

  • Adopting a child or placing a child for adoption or foster care

  • Losing other health coverage

  • Moving to a new permanent residence

  • Gaining citizenship or lawful presence in the U.S.

  • Leaving incarceration

  • Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

For a full list of qualifying life events, see this article.

So, When Can I Buy an Individual Health Plan?

To summarize, you can buy an individual health plan for 2016 starting November 1, 2015. If you need health insurance coverage before then, you may be able to purchase an individual health plan if you qualify for a special enrollment period.

What questions do you have about the 2016 open enrollment period or individual health plans? Leave a comment below.



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