Health insurance can be very confusing for some. This article will go over key aspects of individual health coverage in Florida.
If you missed the open enrollment period for the Affordable Care Act (ACA), you can obtain short term medical coverage until December 31, 2014. Short term medical will cover any accidents or illnesses that arise since the inception of the policy, subject to deductibles, coinsurance and copayments if any. Pre-existing conditions are not covered and they are not guaranteed issue plans, nor are these plans ACA complaint. There are a limited number of insurance companies that offer this coverage. These plans are for individuals that missed open enrollment, they are in between jobs, or will soon be on Medicare.
When outside of the open enrollment period, you are only allowed to enroll in a major medical ACA complaint coverage if you have a qualifying event and you are granted a special enrollment period. You have 60 days to enroll in a health insurance plan following the qualifying event.
Here are a few examples of qualifying events:
- Marriage
- Adopting a child
- Having a baby
- Loss of health coverage, due to job loss, divorce, etc. (voluntarily loss by not paying premiums is not considered loss of coverage)
- A change in immigration status
- Other exceptional circumstances
For open enrollment for 2015 plans, the proposed period is from November 15, 2014 to February 15, 2015. During this period, you can enroll in a plan directly with an insurance company of your choice or if seeking subsidy, through the Health Insurance Marketplace. There is only one lifestyle question, if you are a smoker or not. No health questions are asked, so everyone can get coverage.
Plans ACA- compliant can be HMO, PPO, EPO, POS, HSA plans. These plan differences are explained in another article.
Subsidy levels are discussed in another article as well.
For more information about individual health insurance in Florida call (888) 256-2234, to speak with one of our experts. Since we are licensed insurance professionals, we do not charge to assist you in electing coverage.