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Is it too late to sign up for healthcare?

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The lowdown...
  • Missing the open enrollment dates can leave you without insurance, or underinsured and subject to ACA fees for inadequate coverage
  • Open enrollment for 2018 to 2020 is set to run from November 1 to December 15
  • You can find out if you qualify for a special enrollment period or exemption to avoid the fee for lack of coverage
  • Medicaid and CHIP coverage can be obtained any time during the calendar year
  • There are limited essential coverage policies available through private health insurance sources, but you cannot get health plans through the marketplace after open enrollment without qualifying for a special enrollment period

If you are new to the health insurance market or transitioning to the marketplace or private insurance from employer-sponsored group coverage, knowing the open enrollment dates can save you from experiencing a lapse in coverage.

Open enrollment is set for November 1 to December 15 for the next few years, but you need to check periodically to see if there are any changes or expansions to these dates.

Looking for better and more affordable health insurance? Enter your ZIP code above and compare at least three to four policies today!

Why is it important to stay aware of open enrollment periods?

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Enrollment periods are the window of time provided that allows you the maximum amount of choice in signing up for the health insurance coverage you need.

Once this time period ends, you are seriously limited on the types of health insurance that are available.

Most plans will not be compliant with essential coverage rules and regulations, which leaves you at risk for having to pay fees for not having the required health insurance coverage.

Possible Costs of Missing Enrollment Deadlines

One of the costs to missing the enrollment deadline is the possibility of going without health insurance until the new enrollment period begins. There are options for other coverage, but it is somewhat limited in benefit.

You will also be subject to fees assessed for each month you and other members of your household go without essential coverage health insurance.

The fee is 2.5 percent of the household income, or $695 (per adult) and $347.50 (per child) — whichever is the higher amount.

These fees will come out of your income tax return that is filed the following year. Paying on taxes rather than having taxes returned to you can add up to a costly error.

Open Enrollment

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The open enrollment period for 2018 to 2020 is scheduled to be from November 1 to December 15. This timeframe allows you to search for the best health insurance plan from the marketplace and private options.

You can change plans and switch companies during this time frame. Most plans automatically renew the 19th of December, but you need to check with the marketplace to see if your plan is set up for auto renewal.

Group health insurance plans through an employer may have a different open enrollment period.

Check with your plan administrator to make sure you are aware of the time set aside for enrollment and changes.

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Special Enrollment Periods

A 60-day period granted to an individual due to a qualifying life event is called a special enrollment period.

There are specific incidences that happen in life that are out of your hands or are so dramatic that it demands the ability to have the necessary time to find a health insurance plan.

Group insurance plans sponsored by employers must offer a special enrollment period that is at least 30-days long.

A few of the reasons to qualify for a special enrollment period are:

  • Job loss
  • Health insurance cancellation
  • Death of main insured
  • Adoption
  • Birth of a child
  • Release from incarceration
  • Getting married
  • Moving
  • Loss of Medicare, Medicaid, or CHIP

Exemptions

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You can avoid the expense of fees for not having essential health insurance coverage by applying for an exemption. There are numerous reasons that extensions can be granted.

Everyone would qualify for a short gap extension if the lack of coverage was two months or less. Some of the other reasons for an exemption to the fees are:

  • Financial and life hardship
  • Lack of affordable health insurance plans
  • Death in the family, in conjunction with another exemption
  • Adoption or birth, along with another exemption
  • Being incarcerated
  • Religious health care related group membership
  • Native American tribal membership

Medicaid and CHIP Coverage

Medicaid and the Children’s Health Insurance Program are designed to help those with limited income get essential health insurance coverage.

Applying for marketplace coverage will provide you with information on how to get these benefits if you financially qualify. If you are denied coverage after applying, look for a special enrollment period or exemption to avoid paying a fee for lack of health insurance coverage.

There are some states that have not expanded Medicaid, which means this will not be an option in those locations.

The great part is that these programs can be applied for any time of the year. You do not have to wait for open enrollment.

Coverage Available Outside Enrollment Periods

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You will not be able to sign up for any health insurance plans through the marketplace without qualifying for a special enrollment period.

There are a few limited plans that offer essential coverage through private health insurance sources, but most plans available will not meet ACA regulations.

As a result, you may have to pay the fees for lack of essential coverage, although you will at least be financially protected from a catastrophic health event.

It may seem frustrating to miss out on the open enrollment deadlines with health insurance, but there are a few options available to try and get relief from the fees that are associated with lack of essential coverage.

Contact a health insurance professional that can answer your questions and help direct you to the best plans available right now.

Are you in need of better health insurance no matter the deadline? Enter your ZIP code below and start comparison shopping today?

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