Is it too late to sign up for healthcare?
Plans Inside the Health Insurance Marketplace
When the Affordable Care Act (ACA) was first rolled out, there was some confusion as to when an individual could actually sign up for an insurance policy within the Marketplace. That was all solved with the establishment of an open enrollment period. The primary function of the ACA is to control healthcare costs across the board.
One of the ways that the drafters of the new policy believe that this can be accomplished is through locking people in a certain policy for a year, as opposed to permitting policies and companies to be switched multiple times during the same time period.
The only time a person is now able to change providers within the Marketplace is during the open enrollment window.
The same is true for individuals without insurance that they decide they want to purchase a policy for themselves and any family members. If you do find that you need to switch providers, remember to compare available policies in your area in order to get the best possible coverage for you and your family.
The open enrollment period can change slightly from year to year, but it generally runs for about 3 months from the beginning of November until the end of January. Once the period is closed, individuals are not generally permitted to enroll in a health insurance plan offered in the Marketplace without first qualify for a special enrollment period. These dates are important to remember.
If you are not happy with your current plan and would like to change, you will want to do so within the open enrollment period in order to better streamline the process. If you miss the window, however, do not despair. There are still several options available to you in order to obtain insurance and avoid paying the tax fine levied on your personal income tax return for failure to do so.
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Special Enrollment Periods
With the exception of Nevada, where insurance is available year round both inside and outside of the exchange, you will need to submit proof of a qualifying event in order to enroll during a special enrollment period. Some of the more commonly cited such events include the following:
- Getting Married
- Obtaining Citizenship in the United States
- Giving Birth or Adopting a Child
- Losing Health Coverage Involuntarily
- Permanently Moving To An Area That Contains New Available Health Plans
It is also important to note at this time that Native Americans are exempt from the Open Enrollment Period and are able to obtain health insurance at any time. This goes for Native Alaskans as well. If you do not meet one of the qualifications for the special enrollment period, you will need to wait until the following window of opportunity that will typically begin in November.
If you believe that you qualify for a special enrollment period, keep in mind that the government began to require proof of eligibility for such qualifying events back in 2016.
Even prior to this year, some exchanges in a handful of states were already requiring that such proof be shown prior to being granted a special enrollment exemption, and almost all off-exchange programs will require this as well. If you do have a qualifying life event and would like to enroll in a health insurance plan outside of the open enrollment window, you will want to be sure to have adequate documentation and proof to show.
Health Insurance Outside the Purview of the Affordable Care Act
If you have missed the open enrollment period, and you do not qualify for a special enrollment period, you will need to rely on securing an insurance policy that is not regulated by the ACA. Options here include short-term health insurance plans, plans that contain limited benefit plans, supplemental accident policies, coverage for critical and special illnesses, and certain medical discount plans.
Some policy types mentioned here are actually a good alternative to major health insurance programs in the short run, but it is wise to secure a more comprehensive policy as soon as possible.
That would be as soon as the next open enrollment period or if you do encounter a qualifying event to get you into the special enrollment period. Let us begin with an overview of short-term health insurance policies, which are currently available in all but five states.
This type of coverage is the next best thing to a comprehensive policy. In the past, most of these plans were capped at six months, which will just about get most individuals through to the next open enrollment window. Recently, these plans have been extended in many states to last for up to 364 days. By definition, new federal regulations do cap short term plans at only three months. In reality, however, the Department of Health and Human Services is not taking any action against any policy that is longer than three months at this time. Short term plans issues after April 1, 2017, will need to be limited to no more than three months, however, so this is something that you will want to consider.
The move to limit these policies to only three months is aimed at curbing abuse within the system. It remains to be seen how long this limitation will remain in effect, but it is meant to keep people from relying on short-term policies in deference to the more comprehensive coverage that the ACA is designed to ensure that most Americans have. It is also important to keep in mind that most short term insurance policies will have a lifetime maximum set at between $750,000 and $2 million.
Short term policies are not regulated under the Affordable Care Act, which is why they are permitted to have a benefit limit. You will want to get more comprehensive insurance as soon as possible, but the conclusion here is that this type of insurance is certainly better than no insurance at all. You do not enter a situation where you have a gap in health insurance coverage, as this could result in a hefty penalty being assessed against you.
Explore Your Options to Choose the Best Health Insurance
The Affordable Care Act has opened up a broad range of options for most Americans to obtain health insurance through the Marketplace. These options are limited to the open enrollment period for the most part, so you will want to make note of these events and important dates. In the even that you do find yourself without coverage, you do have options. Those options have been presented here in brief form.
You can shop around for the best coverage in your area and then work from there. If you do have a qualifying event, the Marketplace will be opened up to providing that you can show proper documentation.
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