If you have recently lost your job, you may qualify for a special enrollment period (SEP), which would enable you to purchase creditable health insurance coverage outside of the yearly open enrollment period.

What is creditable coverage?

Creditable coverage is coverage that meets standards set by government bodies, such as the Department of Health and Human Services and the Centers for Medicare & Medicaid Services (CMS). Losing creditable coverage triggers an SEP, which allows you to enroll in a new health plan outside of standard enrollment periods.

What can cause you to lose creditable coverage and trigger an SEP?

You can lose creditable coverage for a variety of reasons, such as if you:

  • Lose your job and your health insurance benefits involuntarily
  • Have your work hours cut and no longer qualify for your employer’s plan
  • Move outside of your plan’s service area
  • Experience other special situations, such as having or adopting a child or getting married

If one of these situations occur, you may qualify for an SEP.

What are your options if you’re under 65?

If you’re under 65 and qualify for an SEP, you can purchase an individual health plan for yourself and your family members.

Individual health plans are available through most major health insurance carriers, including Blue Cross and Blue Shield of Nebraska (BCBSNE) and the Affordable Care Act (ACA) at HealthCare.gov.

Armor Health is BCBSNE’s individual plan option and offers:

  • 100% preventive coverage
  • $0 preferred generic drugs
  • Nationwide coverage

Armor Health is a short-term product and an ACA alternative that members can renew year-after-year. Armor Health plans typically offer a lower premium than ACA plans. However, if you have little or no income, you may qualify for assistance through HealthCare.gov in paying premiums. To learn more, read Five common individual health plan questions: Answered and Five questions to ask yourself when searching for an individual health plan.

What are your options if you’re over 65?

If you’re over 65 and lose creditable coverage, you and your spouse can enroll in a Medicare Advantage or Medicare Prescription Drug Plan during an SEP.

CMS recently identified March 1 to June 30, 2020, as an SEP for individuals impacted by COVID-19. To find out if you qualify for this SEP, visit Medicare.gov/Medicare-Coronavirus.

Who can help you?

If you qualify for an SEP and need assistance, a licensed sales agent can walk you through your options and help you buy a plan that fits your needs. Contact a BCBSNE agent.

For more articles like this one, visit Insurance 101.