Open enrollment period to get children on individual health plans runs through Oct.
September 26, 2011 · Updated 10:56 AM
Parents who need health insurance for their children have until the end of October to enroll them in an individual health plan.
This includes children with pre-existing health conditions, since federal health care reforms prevent insurers from denying coverage to such children.
However, just like employer-sponsored health plans, insurers can create open enrollment periods, and the current one runs through Oct. 31. During these times, children younger than 19 do not have to complete a health questionnaire and cannot be denied health insurance because of a pre-existing condition.
The open enrollment periods apply to all health plans in the individual market. People buying individual plans don’t have access to employer-sponsored coverage, or their employers’ plans don’t cover dependents.
“If you want health insurance for your kids, apply early,” state Insurance Commissioner Mike Kreidler advises. “Waiting to apply can delay your coverage.”
Anyone having difficulty getting coverage can call the Insurance Consumer Hotline at 1-800-562-6900.
If parents miss the open enrollment period and need coverage for a child right away, they can apply to either the Washington State Health Insurance Pool (WSHIP), or if they qualify, to the Pre-existing Condition Insurance Plan (PCIP-WA). To enroll in PCIP-WA, the child must have been uninsured for at least six months and have a pre-existing medical condition.
There are exceptions to the open enrollment periods that allow parents to apply for individual coverage for their children anytime. These include:
• after the birth or adoption of a child;
• if the parent is no longer eligible for a state program;
• if the parent loses coverage due to a divorce;
• if the parent loses employer-sponsored coverage (including COBRA);
• if the parent moves and their plan is not available where they now live.
The next open enrollment period is March 15-April 30. Open enrollment periods for children end in 2014 when the full federal health reforms take effect. Insurers will not be able to deny anyone coverage then because of a pre-existing medical condition.
— Information from Washington state Office of the Insurance Commissioner