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Buying A Health Insurance Plan After Open Enrollment

If you wanted to enroll in an Obamacare health plan for 2018, you will probably be disappointed to hear that the Open Enrollment Period (OEP) ended on December 15, 2017.  The Open Enrollment Period every year allows eligible applicants to shop for health plans sponsored by the Affordable Care Act, enroll and take advantage of significant tax credits to lower monthly premiums. If you missed last year’s OEP, then it may be more difficult to enroll in the Obamacare plan of your choice, but it is not impossible.

Whether or not you are able to sign up for an Obamacare plan for 2018, it is still a good idea to get coverage in some form. By having coverage for the majority of the year, you can avoid the financial penalty created by the ACA’s individual mandate. For this year, the annual penalty can be as high as $695 per adult or 2.5 percent of annual household income. Last year, Congress repealed the individual mandate component of the ACA, but this doesn’t take effect until 2019—so you can still be penalized for 2018.

Furthermore, it is a good idea to have health insurance in general.  Not only will being insured protect your finances if you encounter a medical emergency, but it will also provide access to necessary medical services. You should know that if you require medical care, hospitals must provide emergency services, but only enough to stabilize you.  If you need follow-up care, prescription medications or other health services, you are entirely responsible for it yourself.  That is why 90 percent of the U.S. population currently has health coverage.

Why Obamacare Is So Unique

When President Barack Obama signed the Affordable Care Act into law in 2010, he helped establish a new, inexpensive way for American families to get health insurance.  Under the new law, federal and state governments created the health insurance marketplaces that offered health plans from private insurers. Americans could choose a health plan and apply for federal assistance to help pay monthly premiums on those plans.

For individuals and households that earned between 100 percent and 400 percent of the federal poverty level, they could take advantage of premium tax credits that could take hundreds of dollars off of monthly insurance premiums.  In some cases, these tax credits could lower the monthly premium to zero for select plans in certain areas of the country.  Although the tax credits are a key feature of these plans, if you make more than the income eligibility criteria, you may still enroll in a plan and pay the full premium out of your own pocket.

Obamacare Health Insurance Plans

Along with low premiums, Obamacare health plans also provide top notch health benefits including maternal care, preventive care, immunizations and substance abuse treatment.  The plans available come in four tiers: Bronze, Silver, Gold and Platinum.  Tier plans have different levels of financial protection; lower premium plans require a greater financial responsibility for medical expenses.

How to Enroll If You Miss the OEP

If you failed to sign up for an Obamacare health plan during last year’s Open Enrollment Period, there is still a chance you can enroll through a Special Enrollment Period.  A Special Enrollment Period is the 60-day period following a qualifying life event, in which your life circumstances change.

Here are some of the qualifying life events that may make you eligible for a Special Enrollment Period:

  • Loss of your health coverage due to getting divorced, losing your job, losing your Medicaid or CHIP coverage or expired COBRA coverage
  • Change in marital status
  • Addition of minor child to your household
  • Permanently relocating to another geographic region with different health insurance options
  • Losing coverage from your parent’s health plan
  • A change in income that alters your eligibility for tax credits
  • Your plan being canceled by your private insurer

If you do not see your life change on this list, you may still qualify for a Special Enrollment Period, but you may need to present your unique circumstances to earn approval.

If you encounter one of these life events, you must apply for a Special Enrollment Period through your state or federal health insurance marketplace within 60 days. If you miss this window, you will have to wait until your next Open or Special Enrollment Period to sign up.

How to Enroll If You Miss the OEP

You don’t need to complete the entire application process to determine if you are eligible to sign up during a Special Enrollment Period.  If you visit or your state’s health insurance marketplace website, and answer a few eligibility questions, you can quickly determine if you are qualified.  You may need to provide some documents proving that a life change has actually occurred to complete the application procedure.

Alternatives to Obamacare Health Insurance Plans

For many people who missed Open Enrollment and don’t qualify for a Special Enrollment Period, there are some other options.  You may choose to enroll in a short-term health plan if one is available in your region.  These plans offer protection from catastrophic health emergencies for up to three months, but do not necessarily include all of the benefits that plans governed by the ACA contain.  Furthermore, short-term health plans are also not guaranteed eligibility; an insurer may not allow you to enroll if you have a pre-existing medical condition. Even if they do allow you to enroll, there is no guarantee that you may renew your policy at the end of the three-month term.

Another option to consider is enrolling in Medicaid.  This government insurance program is available to low-income families, disabled persons, seniors and pregnant women.  You may apply for Medicaid coverage at any time of the year, but each state has its own eligibility criteria, so you should check with your state Medicaid agency to learn if you are qualified. Although the application process is streamlined for pregnant women, other applicants may take weeks or months to learn if they are accepted into the program.

To learn more about the Special Enrollment Period, please visit Boost Health Insurance.


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