The individual health insurance market will have two special open-enrollment periods for children this year. Parents who want to add their children to their individual health plans or buy child-only plans can do so from March 15 to April 30, 2011 and from Sept. 15 to Oct. 31, 2011.
Commissioner Kreidler created the open-enrollment periods through a regulation filed today. The individual health insurance market is for people who do not have access to employer-sponsored health insurance.
New consumer protections under the federal Affordable Care Act prevent health insurers from denying coverage to children with pre-existing health conditions. However, special open-enrollment periods are allowed.
During open-enrollment times, children under age 19 cannot be denied health insurance because of a pre-existing condition. People looking for coverage for their children outside of the enrollment dates can apply either to the Washington State Health Insurance Pool (WSHIP), or if they qualify, to the new Pre-existing Condition Insurance Plan (PCIP-WA). To enroll in PCIP-WA, you must have been uninsured for at least six months and have a pre-existing medical condition.
Exceptions where parents can apply for individual coverage for their kids anytime include the birth or adoption of a child or if a child or the parent:
• Is no longer eligible for a state program.
• Loses coverage due to a divorce.
• Loses employer-sponsored coverage.
• Moves and their plan is not available where they live.
In 2014, when the full health reforms take effect, no one of any age can be denied insurance because of a pre-existing condition.
Anyone with questions about the individual health insurance market is encouraged to call our Insurance Consumer Hotline at 1-800-562-6900.