What is Special Enrollment Period Shopping in the World of Health Insurance?

If you urgently need health insurance, it is the right time to get it. Multiple federal regulations concerning health insurance and Medicare have opened up numerous special enrollment periods (SEPs) that allow you to get coverage outside standard enrollment windows.

Special Enrollment Periods (SEPs)

Special Enrollment Periods can have you sign in for health coverage outside or during the annual Open Enrollment Period for an earlier coverage start date. Usually, there is a specific time when you can change your health during the year or when you are going through a life-changing experience. Until you are entitled to the SEP, you can only make changes in your health insurance coverage during annual periods.

The annual election period (AEP) for Medicare is October 15 to December 7. In contrast, the open enrollment period for the Affordable Care Act is generally from November 1 to January 15 but can vary by state.

Special Enrollment Periods can be very accommodating for people who need to change their coverage, like losing their employee coverage, turning 65 or otherwise getting Medicare eligibility, moving to another country or state, or turning 26 and losing coverage from your parent’s insurance.

You can avail these enrollment opportunities as your circumstances change. There are other enrollment options you can choose from that are federally authorized. The Centers for Medicare and Medicaid Services (CMS) have special enrollment periods based on some local, state, and federal conditions for a fixed period, for instance, weather events such as hurricanes, tornados, wildfires, and public health emergencies like the pandemic. Though they are sometimes prolonged, they are temporary and have always end dates.

Recent Medicare Special Enrollment Duration

Emergencies were announced worldwide because of COVID-19 in the early days of March 2020. Because of this, numerous SEPs were made available during the coronavirus pandemic. Even though the widest of these SEPS last till August 2020, you can still make amendments to your coverage if you prove that you were tested COVID positive. This will last till the pandemic ends.

Affordable care act and individual insurance Special Enrollment Periods

Apart from this, there is still one open enrollment opportunity for Affordable Care Act health insurance consumers. FEMA-declared special election periods are applicable in the individual health insurance policies. In states that use the Federal Insurance Marketplace, people whose total household income is below 150% of the federal poverty limit have a fixed enrollment period. Any member of the house who is entitled to the Federal Marketplace plan as well as fulfills the income criteria can use this SEP.

Things you can do during a Special Enrollment Period

Elements of your options vary depending on the conditions of each specific SEP. However, you are generally permitted to make one change in your coverage during the declared SEP. It means that for Medicare, signing in a Medicare Advantage plan, moving from one Medicare Advantage plan to another, dropping Medicare Advantage, and switching from one stand-alone prescription drug plan to another.

The federally announced special enrollment periods have no impact on your Medicare supplements (Medigap).

If you are under 65, SEP allows you and your other qualified family members to register in individual health insurance plans. If you meet the criteria for the SEP at 150% below the federal poverty level, you might be able to change your coverage as you wish, staying under income limits.

How to make the most from your Special Enrollment Period

Special enrollment periods federally declared are dynamic situations – they appear out of nowhere and are unpredictable. Looking at the litany of emergencies that have happened in three years, it can be challenging to have a record of the declared SEPS.

You can also consult a licensed health insurance agent to know if you are eligible for the SEP. The agent will help you explore and compare the plans when they are available. Once you know what suits you, the agent will help you enroll in it and provide you with ongoing services depending on your needs.
Use these tips and make use of it as much as you can!