With all the discussion and debate surrounding the Affordable Care Act (also referred to as Obamacare), chances are good that you signed up for a plan before the deadline. But if for some reason you didn’t sign up before the deadline or during the grace period, you might be panicking and wondering where to go from here. We spoke with a number of health care and insurance professionals to find out what steps you need to take next.
Do you qualify for Medicaid or CHIP coverage?
As Hector De La Torre, executive director of Transamerica Center for Health Studies (TCHS) points out, “If an individual or family qualifies for Medicaid they can sign up for health insurance at any time. The same goes for Children’s Health Insurance Program (CHIP) — registration is always available.”
Did you have a life event?
Some situations allow individuals to sign up for coverage after the open enrollment deadline.
Eric Stauffer, President of ExpertInsuranceReviews.com explains, “There is something called a Qualifying Life Event, which gives people a 60-day window to get coverage.” This can include the following scenarios:
- Birth / adoption of a child
- Death of a spouse or child
- Work or residence change that impacts current health insurance coverage
- Child status changes (student, etc.)
- Coverage is received or lost through work
It’s important to note, however, that each state (and the individual health insurance plans offered in those states) varies on what qualifies as a life event, so residents will need to review their state exchange websites for information.
Do you qualify for alternative coverage?
“There are other insurance products available for enrollment year-round,” Sande Drew, Senior Media Consultant of eHealth explains. “These products can offer some level of protection, although they will not meet your coverage requirements under the Affordable Care Act, and you may still be subject to a tax penalty. Keep in mind that it may be possible to be declined coverage for alternate forms of coverage based on your personal medical history or other risk factors. They may also not provide coverage for pre-existing conditions. Some alternate forms of coverage may include short-term health insurance plans, accident insurance and critical illness insurance.”
If you failed to sign up for a health plan and no exemptions apply to you, you will face some fines. As Hector De La Torre explains, “For those who do not purchase health coverage for at least nine months, the penalty starts at $95 in 2014 per adult and $47.50 per child up to $285 for a family (or 1 percent of income, whichever is greater) in 2014. The penalty increases to $325 per adult and $162.50 per child up to $975 for a family (or 2 percent of income, whichever is greater) in 2015.”