You meant to sign up for Obamacare, but you ran into technical glitches, got busy or just procrastinated. Now the deadline to buy health insurance has come and gone. Is it too late?
The answer: maybe. Through about mid-April, consumers will be able to get an extension by checking a box on the HealthCare.gov website stating that had problems applying for coverage.
Otherwise, most consumers who did not buy health insurance by the deadline of March 31 won't be able to buy any policy -- inside or outside the marketplace -- until fall 2014. But there are some exceptions: for example, if you have a major life change that qualifies you to shop for new insurance.
When's the next enrollment period?
The next open enrollment period, when you can buy a new individual health insurance plan for you or your family, will begin Nov. 15, 2014. And the policies sold during that time won't kick in until January 2015.
"If you didn't sign up, you might be out of luck until then," says Sally McCarty, a senior research faculty member at Georgetown University Health Policy Institute.
So, if the goal of the Affordable Care Act is to get Americans insured, why is there a cutoff date to buy a plan?
"It's so people won't wait until they're sick to sign up for insurance, then drop it when they get better," McCarty says.
How to get health insurance after the Obamacare deadline
However, you can get health insurance after the Obamacare deadline -- under certain circumstances. Here are four ways some consumers will be able to get insurance outside of the open enrollment period:
1. Get an extension.
Americans in 36 states who are shopping in the federal health insurance marketplace might be able to get an extension, but only if they report that they started the application process by the deadline, federal officials announced on March 25.
Why the extension? "There's a lot of traffic (on HealthCare.gov) and glitches that are still being worked out," says Christine Barber, senior policy analyst for the nonprofit Community Catalyst. Some states running their own marketplaces also are offering extensions. The California marketplace will let consumers who started applications by the deadline take an extra two weeks to finish. And all residents of Oregon will have until the end of April to sign up due to massive technical problems. Consumers should check with their state marketplace or department of insurance to see if there's an extension in their state, McCarty says.
2. Have a "qualifying life event."
From HealthCare.gov, here are some examples of qualifying life events:
- You get married, have a baby or adopt a child. Any time a family expands, it's a reason to shop for new health insurance, McCarty says.
- You lose your health insurance. For example, you get laid off and lose your employer-sponsored insurance; get divorced and are dropped from the coverage you had through your spouse; or your COBRA coverage ends. But take note: Losing your coverage because you failed to pay the premiums or just decided to quit doesn't count as a qualifying life event. "It's only when you lose coverage through no fault of your own," McCarty says.
- You make a major move. Maybe you move out of state or return to the U.S. after living in another country. Any move to an area that offers different health plan options qualifies you to shop again.
- You already bought a plan, then have a change in income. If you have insurance through a marketplace, but then your income or family status changes in a way that affects your eligibility for a subsidy or a reduction in cost sharing, you can shop for a new plan.
If you experience one of these events, you get a "special enrollment period" -- a time frame, usually 60 days, during which you can buy insurance through the marketplaces.
However, if you're losing your current coverage, you should buy a new plan by the 15th of the last month you're covered in order to avoid a gap in coverage, according to HealthCare.gov.
3. Qualify to get insured through certain programs.
Both Medicaid and the Children's Health Insurance Program are open to enrollment all year, Barber says. Medicaid is a program that provides health coverage to those who qualify based on income, family size and other factors, such as pregnancy. Consumers in states that expanded Medicaid have a better chance of qualifying than those in states that did not. CHIP provides health coverage to children based on income and family size.
"It can't hurt to check your eligibility," McCarty says.
4. Buy a short-term plan to bridge the gap.
Consumers might be able to purchase a short-term health insurance plan to get them through to the next enrollment period, Barber says. But, these plans don't have to follow ACA rules and don't meet requirements for minimum essential coverage, Barber says. This means these plans don’t have to include the 10 essential health benefits, which are categories, such as emergency care, prescription drugs, and mental health, that the ACA requires health insurance plans to cover. For example, a short-term plan might lack basics such as maternity and prescription drug coverage, she says: "It's not actually a full insurance plan."
There are a few other ways someone might be able to sign up after the deadline, Barber says. For example, if you are an American Indian or an Alaska Native from a federally recognized tribe, you can enroll any time during the year, Barber says. Small-business owners also can use the Small Business Health Options Program (SHOP) exchange throughout the year, she says.
How to prepare for the next enrollment period
So, if you missed this open enrollment period and you need coverage, what should you do to get ready for the next open enrollment period? Experts recommend you take these two steps.
- Create an emergency fund. You'll have to pay for your own medical costs in 2014. Also, if you didn't sign up by the deadline of March 31, 2014, you'll have to pay a penalty of 1 percent of your income above $10,150 (capped at the average yearly cost of a bronze plan) or $95 per person (capped at $285 for a family), whichever is higher. If you sign up during the allotted extension, you’ll likely have to pay a prorated penalty from April 1 until the day your insurance kicks in, McCarty says. It's smart to put money aside, if you can, in case you have a medical emergency, McCarty says.
- Meet with a navigator. It's a good idea to set up an appointment with a navigator, an individual trained to help consumers shop for health insurance, to go over your health insurance needs and discuss general options, McCarty says. Look at the levels of coverage available and what would make more sense for you: higher premiums and a lower deductible or vice versa, she says.