By Christian Regalado
It’s March. Do you have health insurance?
If you’re under 65 and need to buy your own health insurance, finding an affordable, quality health plan for yourself and your family became more challenging for the self-employed and others in the individual marketplace this year. Open Enrollment for 2026 ended January 15, and I saw many families choosing to downgrade their health plans due to increased premium costs. If there’s an upside, one of the most crucial benefits secured by the ACA that remains is guaranteed issue. That means you can’t be denied health coverage because of a pre-existing health condition.
Rumor has it Congress is working on bipartisan solutions to address the drivers of high healthcare expenses here in the U.S.; we’ll see how it goes. In the meantime, we’re working with what we’ve got!
If you are under 65 and uninsured, you’ll need to qualify for a Special Enrollment Period (SEP) in order to enroll in a new health plan for 2026.
There are several events that can trigger a Special Enrollment Period (SEP). The first is if you’ve lost employer sponsored health coverage for any reason. Second, a SEP is triggered if you move to an area outside your existing coverage area. Other qualifying life events such as getting married or having a baby can open a SEP for you. If you have a life event that triggers a SEP, don’t wait to find a new plan. Generally, you only have 60 days from the reported “event” to apply.
For folks turning 65 this year, the important timeline you’ll want to keep in mind concerns your initial enrollment period. You have to take the initiative to enroll in Medicare through ssa.gov unless you’re already collecting Social Security. You can apply as soon as 3 months prior to your birth month or you can delay up to 3 months past your birth month, but unless you have other creditable coverage, you really shouldn’t. Understanding all of Medicare’s moving parts is a bit of a learning curve, and sorting through it with the free services of a local independent broker can be game-changing. If you’re navigating Medicare for the first time this year, I’d be happy to help you through it.
If you’re over 65, there are three common circumstances that may find you enrolling for coverage outside the annual enrollment period. The first would be if you retained insurance through your employer past 65, but are ending that coverage now. In this case, you’re likely already enrolled in Part A. You have 60 days to report your creditable coverage loss and enroll for Part B without penalty. Then you can choose an Advantage Plan or a Supplement and PDP plan to complete your coverage. The second common circumstance is a SEP triggered by a move outside your service area. The third is a Medicare Disaster-related SEP. These are triggered when a natural disaster or storm event happens in your area during a standard election enrollment period.
As usual, broker services are offered at no cost to you, and I will be happy to discuss your options in my office or over the phone. Reach out anytime! Email Christian@evergreenhealthins.com or call (850) 687 7606.
