How to Obtain Health Insurance through Open Enrollment
Ohio law requires certain insurance carriers to offer health insurance at a limited cost to people who apply on a first-come, first-served basis. Under this program, called Open Enrollment, there is a choice of Basic or Standard benefit plans. Participating carriers have a limited number of policies of this type that they must provide by law.
If you meet certain requirements, you can’t be turned down for this coverage even if you are sick. However, insurance carriers are not required to accept applicants who, at the time of enrollment, are confined to a health care facility due to chronic illness or permanent injury.
You must meet either the requirements listed below as a Federally Eligible Individual (FEI) or as a Non-Federally Eligible Individual (Non-FEI), in order to sign up for Open Enrollment coverage. If you qualify as an FEI, your coverage will be effective immediately upon enrollment without pre-existing condition exclusions. If you do not qualify as an FEI, you may still be eligible for coverage as a Non-FEI. However, the carrier may require up to a 90-day waiting period for your coverage to be effective. The carrier also may exclude coverage for pre-existing conditions for up to the first 12 months from your effective date.
You can qualify as a Federally Eligible Individual (FEI), if:
- You had health coverage for at least 18 months without a break in coverage greater than 63 days.
- Your most recent health coverage was under an employer group health plan, governmental plan or church plan.
- You are not eligible for coverage under any of the following plans:
- An employer group health plan,
- You do not have any other health coverage.
- Your most recent health coverage was not terminated due to nonpayment of premiums or fraud.
- If you had been offered the option to continue coverage under COBRA or a state continuation plan, you both elected and exhausted the continuation coverage.
You may need to submit proof of previous creditable coverage.
You can qualify as a Non-Federally Eligible Individual (Non-FEI), if:
- You are not applying for coverage as an employee of an employer, member of an association or member of any other employer group.
- You do not have any other health coverage and are not eligible to be covered under any private or public health benefit plans including the following:
- Medicare or Medicare supplement policy
- Any COBRA or state continuation coverage plan
- Other health benefits arrangement
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This article is meant to give you general information and not to give you specific legal advice. Prepared by Community Legal Aid Services, Inc. Updated May 2012. CE-55-F184-CLAS