Can I Get Health Insurance Any Time of Year in NC?

Missed Open Enrollment? North Carolina residents may still qualify for health insurance through Special Enrollment or year-round plans.

Caught between enrollment periods but need health insurance in North Carolina? You’re not alone! Many North Carolina residents wonder if they’re stuck waiting months for coverage or if other options are available.

The good news is that while there are official enrollment windows, you might have more choices than you realize.

Let’s dive into when you can sign up for health insurance in North Carolina and discover the lesser-known pathways to coverage outside standard enrollment periods.

Can I Get Health Insurance Outside of the Enrollment Window in North Carolina?

Health insurance enrollment generally follows a structured schedule with designated open enrollment periods when most people can sign up for or change their coverage. For most North Carolina residents, these opportunities are limited to specific timeframes during the year.

The Affordable Care Act (ACA) marketplace plans, employer-sponsored coverage, and Medicare all operate on enrollment calendars that restrict when you can start new coverage. However, this doesn’t mean you’re completely without options if you miss these windows.

As your dedicated health insurance advisors with over 25 years of experience assisting North Carolinians, we’re here to help you understand all your options.

When Open Enrollment Happens in North Carolina

The primary opportunity to enroll in health insurance comes during the annual Open Enrollment Period (OEP). During this time, all eligible North Carolina residents can apply for new health insurance plans or switch their existing coverage without needing a qualifying life event.

Open Enrollment 2025 Dates

For ACA marketplace plans in North Carolina, Open Enrollment for 2025 coverage runs from November 1, 2024, through January 15, 2025.

Coverage selected by December 15, 2024, begins on January 1, 2025, while plans chosen between December 16, 2024, and January 15, 2025, start on February 1, 2025.

Open Enrollment 2026 Preview

Looking ahead, Open Enrollment for 2026 coverage is expected to follow a similar timeline, beginning November 1, 2025, and extending through mid-January 2026.

These dates allow North Carolina residents to compare plans and secure coverage for the upcoming year.

If you’re covered through your employer, your company’s open enrollment period may differ from the ACA marketplace dates. Most employer plans offer an annual window, typically lasting 2-4 weeks, when employees can make changes to their benefits.

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Getting Health Insurance Outside Open Enrollment

Missing the Open Enrollment Period in North Carolina doesn’t necessarily mean waiting months for coverage.

Several pathways exist for North Carolina residents to obtain health insurance throughout the year.

Special Enrollment Periods Explained

A Special Enrollment Period (SEP) opens a temporary window for you to enroll in health insurance outside the standard enrollment timeframe. Think of it as an exception to the rules when life takes unexpected turns.

Life Events That Qualify You for Special Enrollment

Qualifying events that unlock your 60-day special enrollment window include:

Loss of existing health coverage (job-based insurance, Medicaid, or CHIP).
Household changes (marriage, divorce, birth, or adoption).
Moving to a new home in a different ZIP code or county.
Income changes affecting your coverage eligibility.
Becoming a U.S. citizen or gaining lawful presence status.

Once one of these events happens, the clock starts ticking! You typically have just 60 days to select a new health insurance plan. Miss this window, and you’ll likely need to wait until the next Open Enrollment Period rolls around.

Remember that you’ll need to back up your claim with proper documentation. Health insurance providers require verification that your life event actually occurred before granting special enrollment access.

Year-Round Health Insurance Options in North Carolina

Several health insurance options remain available throughout the year, regardless of enrollment periods:

Medicaid and NC Health Choice

North Carolina’s Medicaid program and NC Health Choice (children’s health insurance) accept applications year-round. Eligibility depends on income, household size, and other factors.

As of 2023, North Carolina expanded Medicaid, making coverage available to more residents with lower incomes.

At Carolina Insurance Professionals, we help you navigate the Medicaid application process and determine if you qualify under the expanded guidelines.

Employer-Sponsored Coverage

If you start a new job that offers health benefits, you typically don’t need to wait for an open enrollment period. Most employers allow new hires to enroll in benefits shortly after starting work, usually within 30-90 days.

Our team works with both individuals and businesses to ensure everyone understands their Group Health Insurance options.

Short-Term Health Plans

While not offering the comprehensive coverage of ACA-compliant plans, short-term health insurance policies can provide temporary protection when you’re between more permanent coverage options.

These plans have fewer benefits requirements and can exclude pre-existing conditions, but they can be enrolled in at any time.

We partner with top providers like Blue Cross Blue Shield NC, UnitedHealthcare, Cigna, Ambetter, and Aetna to offer a wide range of health insurance solutions that fit your specific circumstances.

A small pile of wooden blocks, each labeled with a health insurance icon (like a cross, a syringe, and a fluid drop) sits on top of a table against a blue backdrop.

Finding the Right Coverage for Your Needs

When exploring health insurance options outside Open Enrollment, consider:

Coverage level needed based on your health status and anticipated medical needs.
Premium costs and how they fit into your monthly budget.
Provider networks and whether your preferred doctors and facilities are included.
Prescription drug coverage if you take medications regularly.
Out-of-pocket costs, including deductibles, copays, and coinsurance.

Our family-owned business has been assisting North Carolinians for over 25 years with their health insurance needs. We take pride in educating you, analyzing your current situation, finding out what’s important to YOU, and finding the right plan that fits YOUR needs.

And the best part? We do NOT charge broker fees for our services! The premium you pay will never be more than going directly to the insurer or the Marketplace, and if you’re already in the right plan, we’ll let you know that too.

So, Can I Get Health Insurance Any Time of Year?

Yes. While the most straightforward path to comprehensive health insurance follows the standard enrollment periods, North Carolina residents have several ways to obtain coverage throughout the year. The key is understanding which options apply to your specific situation and acting promptly when qualifying events occur.

For personalized guidance on your health insurance options, our team of experienced Raleigh-based agents is ready to help. We’ve been assisting North Carolina residents for 25 years and understand the challenges of finding the right coverage at the right time.

Don’t navigate the health insurance maze in North Carolina alone! Contact us or give us a call at 919-285-4732 to schedule your consultation!

Our friendly North Carolina insurance experts will help you find the perfect coverage for your situation—whether you’re in an enrollment period or need to explore special enrollment options tailored just for you.

Posted in Health | General Info, Health | Open Enrollment, Open Enrollment