Jane Dotson
Being in between medical insurance plans can be a stressful situation, but there are several options to consider. Firstly, it is important to understand that losing health insurance, whether job-based or otherwise, may qualify you for a Special Enrollment Period, allowing you to enroll in a new plan outside the usual Open Enrollment Period. This period can be used to explore different insurance plans and choose one that suits your needs. Short-term health insurance is another option to bridge the gap until you can select a long-term solution. These plans are medically underwritten and may not cover pre-existing conditions or provide the same benefits as Minimum Essential Coverage under the Affordable Care Act. Additionally, individuals can take advantage of free or low-cost coverage options such as Medicaid or the Children's Health Insurance Program (CHIP), depending on their income level. It is crucial to carefully review plan details and consult official websites to understand your rights and make an informed decision.
| Characteristics | Values |
|---|---|
| Losing job-based health insurance | Apply for a plan through the Health Insurance Marketplace |
| Enroll in COBRA continuation coverage to stay on your job-based health insurance for a limited time after your job ends | |
| Apply for free or low-cost coverage from Medicaid or the Children's Health Insurance Program (CHIP) | |
| Apply for a Special Enrollment Period to enroll in or change Marketplace plans outside of Open Enrollment | |
| Short-term health insurance can fill the gap in coverage until you can choose a longer-term solution | |
| Short-term health insurance is medically underwritten and may not cover all Essential Health Benefits in your state | |
| Short-term health insurance does not cover pre-existing conditions |
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What You'll Learn
Apply for a Special Enrollment Period plan
A Special Enrollment Period (SEP) is a period of time outside of the yearly Open Enrollment Period when you can sign up for health insurance. SEPs are triggered by certain life events, such as losing health coverage, moving, getting married, having a baby, adopting a child, or if your household income falls below a certain amount. You may also qualify for an SEP if you have experienced a change in your previous coverage that makes you eligible for savings on a Marketplace plan.
To apply for a Special Enrollment Period plan, you will need to report your qualifying life event to the relevant body, such as the NY State of Health or HealthCare.gov, within 60 days of the event occurring. You may also need to provide proof of the qualifying life event to your new health plan. For example, if you have lost your health insurance through your job, you may need to provide proof of this when applying for Marketplace coverage.
It is important to note that not all events qualify you for an SEP. For example, moving for medical treatment or vacation does not qualify you for a Special Enrollment Period. Additionally, if you chose to drop your coverage, you will not qualify for an SEP unless you also had a decrease in household income or a change in your previous coverage that makes you qualify for savings on a Marketplace plan.
Short-term health insurance, also known as temporary health insurance, can be an option to fill the gap in coverage until you can choose a longer-term solution. Short-term plans are medically underwritten and may not cover pre-existing conditions or provide the mandated coverage necessary to avoid a penalty under the Affordable Care Act. Be sure to carefully review the policy to understand any exclusions or limitations.
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Consider short-term health insurance
If you're between medical insurance plans, you might want to consider short-term health insurance. This type of insurance provides temporary medical coverage when you're between plans, outside of enrollment periods, or need coverage in an emergency. Short-term health insurance is typically much more affordable than major medical plans, with monthly premiums starting at under $100. However, it's important to note that short-term plans lack the benefits of ACA major medical plans, such as coverage for pre-existing conditions, and may not be available in all states.
Short-term health insurance plans are designed to provide coverage for a limited period, typically less than 365 days. These plans are available from several national and regional companies, but the availability of short-term plans varies depending on the state and can change from year to year due to insurer business practices and evolving state regulations. In 2025, there were 15 states, including DC, where no short-term plans were available due to bans or unattractive state laws.
Short-term health insurance can be purchased online or, in some cases, through paper applications or in-person enrollment. The monthly premiums vary depending on your location, age, and the insurance company offering the coverage. While short-term plans are more affordable, they also provide limited coverage compared to ACA-compliant plans and may not cover pre-existing conditions. Additionally, short-term plans are not considered minimum essential coverage, so you won't be eligible for a special enrollment period when the plan terminates.
When considering a short-term health insurance plan, it's important to read the "`exclusions and limitations`" information to understand what is covered and what is not. These plans typically cover preventive care, doctor visits, urgent care, emergency care, and sometimes prescriptions. They may also offer cost savings for using in-network providers. However, the deductibles on short-term plans can be significantly higher than those of traditional health plans.
Short-term health insurance can be a good option for those who need limited health coverage during transitional periods when ACA major medical plans are unaffordable or unavailable. However, it's important to understand the trade-offs in coverage and costs before deciding if a short-term plan is right for your situation.
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Keep your job-based insurance with COBRA
If you've lost your job, you can maintain your job-based health insurance through COBRA, or Consolidated Omnibus Budget Reconciliation Act, coverage. This lets you pay to stay on your job-based health insurance for a limited time—usually 18 to 36 months—after your job ends. This temporary coverage can be helpful if you want to continue seeing the same doctors and receiving the same health plan benefits. Your spouse, former spouse, and children are also eligible for COBRA coverage, even if you don't sign up for it yourself.
COBRA coverage can be expensive, as you may have to pay the entire group rate premium out of pocket, plus a 2% administrative fee. However, it can provide a valuable safety net when you're between jobs, and you can explore COBRA continuation coverage options, eligibility, and benefits under HIPAA regulations. You will receive a notice from your employer with information about deadlines for enrollment, and you typically have 60 days from a qualifying event (such as job loss, divorce, or death of a spouse) to enroll.
If you're unemployed, you may also be able to get an affordable health insurance plan through the Marketplace, with savings based on your income and household size. You can compare Marketplace plans and prices to your COBRA coverage options. From January 16 to October 31, you can switch from COBRA to a Marketplace plan if your COBRA coverage is running out, you have to pay the full cost, or you lose a government subsidy. During the open enrollment period from November 1 to January 15, you can enroll in a Marketplace plan regardless of why you're ending COBRA coverage.
In addition to COBRA and Marketplace plans, there are other coverage options to consider when you're between jobs. You may be able to join your spouse's employer plan or enroll in a trade or professional group plan through organizations like the National Association for the Self-Employed or the Freelancers Union. If you're a low- to moderate-income family, you can apply for the Children's Health Insurance Program (CHIP). Short-term health insurance plans can also fill the gap in coverage until you choose a longer-term solution. These plans may not cover all Essential Health Benefits and typically don't cover pre-existing conditions, so be sure to carefully review the policy for any exclusions or limitations.
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Apply for Medicaid or CHIP
If you are in between medical insurance, you can apply for Medicaid or the Children's Health Insurance Program (CHIP). These programs provide free or low-cost health coverage to eligible individuals and families, including low-income people, children, pregnant women, the elderly, and people with disabilities. The requirements vary depending on the state, so it is essential to check with your state's Medicaid agency to see if you qualify.
To apply for Medicaid or CHIP, follow these steps:
- Create an account with the Health Insurance Marketplace: Visit the Health Insurance Marketplace website and create an account to start your application. You will need to provide basic information such as your name, contact information, and household size.
- Fill out the application: Complete the application by providing information about your income, household composition, family status, and any other relevant details. Be prepared to submit documentation or proof of your income, insurance status, and residency. The specific requirements may vary depending on your state, so check with your state's Medicaid agency beforehand.
- Submit the application: Once you have completed the application, submit it through the Health Insurance Marketplace. Your information will be sent to your state agency for review.
- Wait for a response: After submitting your application, wait for a response from your state agency. They will review your information and determine your eligibility for Medicaid or CHIP. If you are eligible, they will contact you about enrollment and provide further instructions. If you are not eligible, they will notify you and explain the reasons.
- Follow up as needed: In some cases, your state agency may require additional information or documentation to process your application. If they need more details, they will contact you. Respond to any requests for additional information promptly to ensure your application is processed without delay.
Remember that even if you don't qualify for Medicaid based on your income, you may still be eligible for CHIP or other cost-saving options. Additionally, Medicaid may be able to help you pay for medical care received in the last three months, even if you were not enrolled at the time. Therefore, it is worth applying and exploring all your options to ensure you have access to the healthcare coverage you need.
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Enroll in a Marketplace plan
If you are in between medical insurance plans, you may qualify for a Special Enrollment Period to enroll in a Marketplace plan. This period is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount. For example, if you lose your job-based health insurance, you may qualify for a Special Enrollment Period to enroll in a Marketplace plan. You may need to provide proof that you lost your health insurance and submit documents to confirm your loss of coverage.
The Open Enrollment Period for the Health Insurance Marketplace typically runs from November 1 to January 15 each year. If you select a plan by the deadline in December, you can get full-year coverage starting in January. If you select a plan after the December deadline but before the final deadline in January, your coverage will start in February.
When enrolling in a Marketplace plan, you can preview plans and estimate prices based on your income. You may also be eligible for financial assistance or premium tax credits to help lower your monthly insurance payment. It's important to carefully review the terms and conditions of the Marketplace plan, as some plans may have limitations or exclusions regarding coverage of pre-existing conditions or specific health benefits.
Short-term health insurance plans are also available if you don't qualify for a Special Enrollment Period. These plans can provide temporary coverage until you can choose a longer-term solution during the next Open Enrollment Period. However, short-term plans may not provide essential coverage as defined by the Affordable Care Act and may not cover pre-existing conditions.
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Frequently asked questions
Short-term health insurance is a temporary solution that can fill the gap in coverage until you can choose a longer-term option. Short-term plans are medically underwritten and are not required to comply with certain federal market requirements for health insurance.
You may be able to keep your job-based health plan for a limited time after your job ends with COBRA continuation coverage. You can also apply for free or low-cost coverage from Medicaid or the Children's Health Insurance Program (CHIP). Additionally, you can enrol in a Marketplace plan during the Open Enrollment Period, which is from November 1 to January 15 each year.
The Special Enrollment Period is a period outside of the Open Enrollment Period when you can enrol in or change Marketplace plans due to a life event or based on your income.
Short-term health insurance plans may have exclusions or limitations regarding coverage of pre-existing conditions and health benefits such as hospitalization, emergency services, prescription drugs, and mental health services. Be sure to carefully review the policy to understand any exclusions or limitations.
You can contact your insurance agent or the company to inquire about costs and complete details of the coverage. You may also be able to find short-term plans through online searches or by reaching out to insurance companies directly.
