After open enrollment 2015: 10 ways you can still get Obamacare
Another Obamacare open enrollment period has come and gone.
For most Americans, it’s now too late to sign up for health insurance coverage. Feb. 15 was the last day to choose a health plan.
People who didn’t purchase a plan by that date now are without coverage and face potential financial penalties.
However, there are some exceptions to this rule. For starters, the federal government recently announced a temporary special enrollment period that allows many Americans who did not have coverage in 2014 to apply for insurance this year between March 15 and April 30.
And even after that time period expires, you may be able to shop for a new Obamacare plan if you experience certain types of life events that qualify you for a special enrollment period.
“If people are having that change in their lives, and they have the opportunity to continue coverage through that life change, (special open enrollment periods) make a lot of sense,” says Anthony Wright, executive director of the health care consumer advocacy coalition Health Access California.
10 changes that qualify for special enrollment
Losing health insurance coverage is the main type of life change that qualifies you for special enrollment.
This may include times when your insurance disappears due to job loss, divorce, the end of COBRA coverage, aging off a parent’s policy when you turn 26, or losing coverage in Medicaid or the Children’s Health Insurance Program.
Nine other events that qualify you for a special enrollment period are:
- Moving to a new state.
- Changes to income that alter your eligibility for premium tax credits or cost-sharing reductions.
- Having a baby or adopting a child.
- Leaving incarceration.
- Gaining membership in a federally recognized Indian tribe, or as an Alaska native shareholder.
- Being overwhelmed by exceptional circumstances. These include a medical situation or natural disaster that kept you from enrolling before the deadline.
- Encountering misinformation or misrepresentation during enrollment.
- Experiencing various types of errors during the enrollment process.
The federal government offers a screener tool at the Healthcare.gov website that can help you determine whether you qualify for a special enrollment period.
When does coverage begin?
Special enrollment periods begin the moment the life change occurs.
“The ‘clock’ starts on the date the triggering event occurs,” says Elizabeth Hagan, senior enrollment policy analyst at Families USA, an advocacy group that promotes health care for all Americans.
In some instances — such as if you know you are about to lose job-based coverage — you can apply for coverage in anticipation of the event occurring, Hagan says.
Pregnancy is another example of where people can be proactive about getting new insurance coverage, says Clare Krusing, spokeswoman for America’s Health Insurance Plans (AHIP), the health industry trade association.
“Coverage begins the day that baby is born,” she says.
If you experience a major life event, the first step is to inform the health insurance marketplace that it has occurred. The government urges you to do so as quickly as possible.
If you have an account in the federal health insurance marketplace, you should log in and follow the procedure for alerting the health insurance marketplace of the life change, Krusing says.
When you get to the site, click the “Report a life change” button. You can also report changes by phone at 800-318-2596.
It’s important to note that changes can’t be reported by standard mail.
After you disclose the changes, the government will let you know if you’re eligible to switch plans and whether you qualify for any additional savings.
Hagan also says that state marketplaces may have established their own rules about what counts as an “extraordinary circumstance” giving people a right to a special enrollment period.
For example, she notes that in Maryland, becoming pregnant triggers a special enrollment period. Currently, the federal rules say pregnant women do not qualify for special enrollment until after they give birth.
She urges you to check with your own marketplace if you have questions.
Special enrollment period deadlines
People who are looking to change their individual health insurance plan have a period of 60 days after one of these events to make the change.
Policyholders in plans provided by your place of employment have 30 days after a life event to choose new insurance coverage.
Those tight timeframes require people to educate themselves and act quickly.
Miss the deadline, and your options for health insurance coverage dwindle unless you have another qualifying life event, Hagan says.
“If a consumer doesn’t apply for coverage within the 60-day time frame, they’ll have to wait until the next open enrollment period to enroll in coverage,” she says.
If all of this seems overwhelming, it may be time to seek a little help, says Joan Sheforgen, interim executive director of the Illinois-based Campaign for Better Health Care.
“Get thee to a navigator,” she says.
Navigators are trained enrollment professionals who are able to answer your questions and help you enroll in the right plan. You can search for a navigator at the Healthcare.gov site. These services are free.
“Choose the organization nearest you to make an appointment,” Sheforgen says.
And Wright urges you not to delay.
“When you’re uninsured, you are one emergency away from financial ruin,” he says.