It’s January 16th and you wake up in a state of panic. You’ve missed the Open Enrollment Period by a few hours, and you don’t know what to do. Take a deep breath, brew a cup of coffee, and get ready to do some reading! Today, we’re going to explore some health insurance alternatives.
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Youth
Many young adults fail to realize they can utilize their parent’s health insurance plan. If you’re under the age of 26, you are eligible to remain on your parent’s plan regardless of whether you live at home, are financially dependent, are married, or are eligible for employer coverage.
Special Enrollment
If you’ve experienced a life-changing event, then you can purchase a health program outside the Open Enrollment Period. Instead, you’ll have to enroll for special enrollment, which involves filling out a form on HealthCare.gov.
In the insurance world, when individuals or households experience a life-changing event, it’s called a qualifying event. We’ve written down the basic examples below:
- Getting married
- Having a baby or adopting a child
- Getting a divorce or separation
- Moving to a new ZIP code
- Losing your job
It’s important to note that you have 60 days after the qualifying event to apply for special enrollment; otherwise, you’ll have to wait until the next Open Enrollment Period. Once you get approval, you can then shop around for a plan either in the state-based exchange or the federal marketplace (depending on where you live.)
Medicaid
Say you can’t afford to purchase a health insurance plan during the Open Enrollment Period, what do you do? Medicaid is a federal program that provides basic health care coverage to millions of impoverished Americans. While the program is funded by Washington DC, eligibility is controlled by each state. This means criteria vary significantly: In states that adopted the ACA Medicaid Expansion (the majority), eligibility is based solely on income (up to 138% of the Federal Poverty Level). In non-expansion states, eligibility is much narrower, often restricted to specific categories like children, pregnant women, and the disabled.
What does this mean? Depending on where you live, the criteria to qualify for the program may be different. There’s also no Open Enrollment Period for Medicaid, meaning Americans can apply throughout the year. According to recent estimates, more than 74 million individuals utilize both Medicaid and CHIP, which we’re going to discuss in the next section.
CHIP
This program is similar to Medicaid, but it focuses solely on providing low-cost health insurance to children and teens. Families who don’t qualify for Medicaid often use this program, which covers basic health and dental coverage. Just like Medicaid, you don’t need to wait for the Open Enrollment Period.
Short-Term Insurance
If you don’t qualify for special enrollment or one of the federal programs mentioned above, you can apply for a Short-Term, Limited-Duration Insurance (STLDI) plan. WARNING: New federal rules (for 2026) restrict the maximum total duration of these plans to four months (3 months initial term + 1 renewal). These plans do not cover pre-existing conditions and are generally only useful to cover unexpected emergencies for a very short period.
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