Individual & Family Health Insurance Plans — this is your choice if you do not have employer-provided insurance, if you are planning on full or semi-retirement before you become eligible for Medicare (age 65 for most people) or if you otherwise need to buy your own health insurance.
Health Insurance Plans are issued by private health insurance companies or carriers. They are often categorized into Comprehensive and Short-Term Plans.
The major distinctions between the two:
Some people refer to short-term plans as "just-in-case" plans because they typically provide coverage, up to a pre-set limits, for accidents or unforeseen illnesses for people that do not have a comprehensive health insurance plan. Short-term plans are not usually meant as a long-term replacement for comprehensive plans because short-term plans generally do not cover items that many people need in the long-term, such as preventive care or coverage for pre-existing conditions.
States that currently significantly limit or do not allow short-term plans include California, Colorado, Connecticut, Hawaii, Massachusetts, New Jersey, New York, Rhode Island, Vermont and Washington (as of April 2019.) As an additional incentive for people to maintain comprehensive health insurance, some states may assess a tax penalty for people who do not maintain qualifying health insurance. Short-term plans do not count as qualifying health insurance. This tax penalty may affect residents of Massachusetts, New Jersey, and the District of Columbia in 2019, and Vermont in 2020. Additional states are considering adopting this tax penalty because the federal government stopped enforcing this penalty in 2019.
Everyone in the United States should carry health insurance given the cost of healthcare in this country. There are a number of health insurance plans and options out there ranging from limited, short-term coverage, to more comprehensive coverage across a broad range of products and services. The best plan and value for you will depend on your needs and budget.
The short answer is yes—plans change and your coverage needs are likely to change over time. We recommend that you review your coverage needs during OEP, connect with a licensed insurance agent and see if there are opportunities for you to save on your overall health costs. Things that could change include:
In addition, if you have a short-term plan, OEP is the best time to consider upgrading to a comprehensive health insurance plan. Outside of OEP, only people with qualifying life events can buy comprehensive health insurance plans.
Comprehensive health insurance plans are typically available for purchase during the Open Enrollment Period (OEP). There is a set time every year when anyone can apply for a comprehensive health insurance plan. At other times of the year, you need to have a qualifying life event (such as a change in family status or loss of other coverage) to buy these plans. The Open Enrollment Period generally runs from November 1st through December 15th each year, but the exact dates may vary by state or year. When you sign up for a plan during OEP, coverage will typically start January 1st of the next calendar year.
You may be eligible for Special Enrollment Period (SEP), meaning you can buy a comprehensive health insurance plan outside OEP. Generally, you have 60 days to apply if you have a qualifying life event such as: