With just under six months left to go until the next open enrollment period for health insurance begins, those without coverage may be wondering what to do until November 1st. If you missed the open enrollment deadline for 2015, then your options for getting covered are bit more limited, but you still may be able to sign up. You may have to pay the penalty fine when you file your taxes next spring, but there are options for protecting yourself and your family against costly medical emergencies.
Special Enrollment Periods
The government allows American to sign up outside of the Open Enrollment period for those that have experienced “qualifying life events.” This is designed to help people who experience significant life changes such as if you lost your job recently or you were married. Other “qualifying life events” include (but are not limited to):
- Change in your income (increase or decrease)
- Moving to a new location
- Having or adopting a child
- Becoming a citizen
- Getting married or divorced
- Suffering a death in the family
- Technical issues that prevented you from enrolling during Open Enrollment
- Gaining citizenship or lawful presence in the U.S.
- Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder
- Leaving incarceration
Once your life event occurs you have 60 days to enroll in health coverage. So let’s say that you have a baby on June 5. Your window to enroll ends (e.g. your “special enrollment period”) runs through August 5. After this date, you’ll have to wait until the general Open Enrollment Period starts again on November 1st.
Medicaid & CHIP
One of the most significant changes that the ACA made was to expand Medicaid to people who may not have qualified before. These individuals and families may have just missed the cutoff for income qualification. So far, 27 states along with the District of Columbia have opted to expand their Medicaid programs.
A handful of other states are considering future expansion. If you live in one of these states and don’t have health insurance, then check to see if you qualify under the new guidelines. You can sign up for Medicaid or the Children’s Health Insurance Program at any point during the year by visiting HealthCare.gov. Government assistance programs don’t follow the strict enrollment period schedule, but it may take time to enroll depending on the volume of sign-ups when you try.
If you live in one of the states that did not expand Medicaid, then you may qualify for an exemption from the penalty fee if you would qualify for Medicaid under the new guidelines. In 2015, the qualifying income level is 138 percent of the federal poverty line. This equates to $16,243 for an individual and $33,465 for a four-person family. Keep in mind that this exemption will keep you from paying the penalty fine on your taxes, but it doesn’t offer any kind of health insurance.
If you don’t qualify for a special enrollment period, Medicaid or an exemption, then you probably won’t be able to sign up for an ACA/Obamacare health insurance plan. Private insurers stick with the enrollment schedule imposed by the federal government in an effort to level the playing field for consumers. For 2016, the sign-up period runs from Nov. 1, 2015 through Jan. 31, 2016. If you need or want health insurance before that time, then you should consider short-term coverage.
Short-term health insurance, gives people the opportunity to protect themselves against medical crises. These plans typically don’t cover pre-existing conditions, preventive medical care or other benefits offered under ACA-compliant plans. They do cover emergencies, ambulance transport, some surgeries and other similar benefits. You can buy a short-term policy that lasts from 30 days to a year depending on the company. These plans don’t count as minimum essential coverage under the ACA so you’ll still have to pay a tax penalty at the end of the year, but they do offer peace of mind for unexpected medical emergencies.