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How do I find a QSEHRA-compatible health insurance plan outside of Open Enrollment?
How do I find a QSEHRA-compatible health insurance plan outside of Open Enrollment?

I need insurance that qualifies as Minimum Essential Coverage for my company's QSEHRA, and it's not Open Enrollment. What are my options?

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Written by Support
Updated over a week ago

Are you searching for QSEHRA-compatible health insurance outside of Open Enrollment? Here are a few options if you are looking to secure health coverage that meets Minimum Essential Coverage (MEC) and participate in QSEHRA this year!

Major Medical Plans

Do you have a Qualifying Life Event in order to apply for a major medical plan?

The period outside of Open Enrollment is called Special Enrollment. During Special Enrollment, you have to have a qualifying life event in order to apply for a major medical plan. This includes things like moving to a new service area, getting married, or losing group insurance coverage (for reasons other than non-payment or voluntary cancellation). Here is a more comprehensive list of qualifying life events.

Starting in 2020, becoming eligible for a QSEHRA will qualify you for a Special Enrollment period with the health insurance exchange. This means that you'll have 60 days before the start of your QSEHRA, or 60 days within the date you become eligible for QSEHRA, to apply for  major medical plan.

If any of these apply, you are eligible within 60 days of your qualifying event to apply for a major medical, on-exchange plan. Ask us for more information about how to find a plan, based on where you live!

Even though an enrollment period starts 60 days following the day of the event, in most cases you can enroll up to 60 days before the event. This allows your coverage to start on the day of the event and allows people to avoid any gaps in coverage. Please note you will need to prove your qualifying event!

Alternative Plans

If you don’t qualify for a special event, here are some alternative plans that are limited to policies not regulated by the ACA. It's important to note that these are different than traditional plans in that they often don't cover pre-existing conditions and the coverage is less overall. However, these plans may be more affordable than traditional plans and they are available for purchase year-round.

Short-Term Plans + Preventative MEC Plans

Short-term plans are typically much cheaper than major medical plans which makes them attractive and available year-round. While they typically cover trips to the ER  and hospital care, many of the most popular short-term plans exclude four categories of essential health benefits since they are not controlled by the ACA: preventive services, maternity care, mental health and substance use services, and prescription drugs. This means that short-term plans are not Minimum Essential Coverage and do not qualify for QSEHRA on their own. However, you can supplement your short-term plan with a Preventative MEC plan, and then you can claim reimbursement for both of the monthly premiums.

If you're interested in this option, here are a few resource:

Faith-Based Sharing Plans

NOTE - sharing plans are not reimbursable under QSEHRA, but, plan permitting, may be reimbursed outside of QSEHRA on a taxable basis. Please check with your plan administrator to confirm whether sharing plans are reimbursable through your company's plan with Take Command Health. In order to claim tax-free reimbursement for medical expenses, you must purchase a preventative MEC plan to supplement your sharing plan. Learn more about QSEHRA+Sharing Plans here.

Sharing plans like Medi-Share are not traditional insurance. They are organizations through which members share healthcare costs with one another. Popular sharing plans include: Medi-Share, Liberty HealthShare, Christian Healthcare Ministries, Samaritan Ministries, Altrua HealthShare, and Shared Health Alliance among others.  

North American Health Plans:

North American Health Plans is a partner who can help you find an alternative plan with your QSEHRA allowance in mind. They offer a suite of products that can be combined for a personalized insurance solution, including fixed benefit plans, critical illness, accident protection, dental, and vision, and they will always include a MEC plan to be sure you are QSEHRA-compatible. 

If you're interested in being connected to them, reach out and ask us for help so we can put you in touch!

For more information, please see our Reimbursement Guide

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