Individual

Missed the open enrollment deadline? Don't panic.

by Larissa

The deadline for health insurance for next year was this past Friday, December 15th. With a shorter open enrollment period and less funding for awareness programs, it’s no wonder that many people missed the deadline to secure coverage for January 1st. While the individual mandate will likely be repealed by the tax bill expected by the end of the year, it is still the law of the land at the moment. That means if you don’t have health insurance coverage, you will have to pay 2.5% of household income or $695 per person, whichever is higher.  If you missed the open enrollment deadline, there’s a chance you have a bit more time. If you don't qualify for more time, you still have options. Here’s what you need to know.

You might have more time

You might have more time if:

  • You live in Connecticut, Maryland, Rhode Island, Colorado, Minnesota, Washington, Massachusetts, D.C., California or New York. These states have extended their deadlines anywhere from one to six weeks.
  • You were affected by a hurricane this past year in Georgia, Florida, South Carolina and certain parts of Louisiana and Texas. If this is you, you have until December 31st.
  • You are a Native American or eligible for Medicaid / CHIP (you can enroll any time if this is the case).
  • You have a life qualifying event (more on what this means below)

Qualifying Life Events

If you missed the deadline for selecting your new healthcare coverage for 2018, you may still be in luck. You can enroll as late as December 31st, 2017 for a Health Insurance Marketplace plan if you have any of the following eligible life events. Even though an enrollment period starts 60 days following the day of the event, in most cases you can enroll up to 60 days before the event. This allows your coverage to start on the day of the event and allows people to avoid any gaps in coverage. Also, note that you will have to prove that you’ve had a qualifying life event. They won’t just take your word for it.

So, do any of these apply to you?

Changes in household

You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

  • Got married.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Death. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and you’re no longer eligible for your current health plan as a result of their death.

Changes in residence

  • Household moves that qualify you for a Special Enrollment Period:
  • Moving to a new home in a new ZIP code or county
  • Moving to the U.S. from a foreign country or United States territory
  • A student moving to or from the place they attend school
  • A seasonal worker moving to or from the place they both live and work
  • Moving to or from a shelter or other transitional housing. You must prove you had health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.

Loss of health insurance

  • If you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
  • Losing job-based coverage
  • Losing individual health coverage for a plan or policy you bought yourself. There are several carriers leaving certain states or the entire individual market altogether.
  • Losing eligibility for Medicaid or CHIP
  • Losing eligibility for Medicare
  • Losing coverage through a family member

Additional qualifying changes

  • Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Leaving incarceration
  • AmeriCorps VISTA members starting or ending their service

If you don’t qualify for an extension, here’s what to do.

If you missed the open enrollment deadline, don’t live in a state with an extended open enrollment period, and aren’t expecting a life qualifying event, your options for 2018 coverage are limited to policies not regulated by the ACA. These include:

  • Pivot: We offer short-term insurance solutions through Pivot to cover you until a qualified major medical health plan is chosen, helping reduce your financial risk. Pivot plans are renewable 90 day plans which in most states can be automatically renewed four times without additional medical screening to provide up to 12 months of continuous coverage. While the maximum time might change in the coming months due to policy changes, for now it means you have an entire year of coverage. Short-term plans are very affordable but have certain restrictions and exclusions you should be aware of (it doesn’t cover pre-existing conditions or preventative care). One downside to note is that you are still subject to a tax penalty. 
  • Medi-Share: you can sign up for a faith-based plan any time. Medi-Share is available in all 50 states and it's managed by PHCS (Private Healthcare Systems, now owned by Multiplan). It has a legit PPO network that provides flexibility to see your doctors and it covers out-of-network expenses as long as it meets Medi-Share’s faith-based guidelines. Medi-Share won’t be for everyone, but is a worthy option to consider if it fits your personal convictions and lifestyle. Make sure to check out our Medi-Share review and compare it to other major medical plans on our website before you enroll.

How Can Take Command Health Help?

Please visit our website and we'll walk you through your options, even if you missed the open enrollment deadline. Our goal is to help you get the most out of your money and find the plan that really works for you and your family.

We also have a premier membership that you can sign up for any time, including some pretty awesome deals for our members. Call a doctor 24/7 for $0, medical bill negotiation support, dental, vision, and pharmacy discounts, etc. In addition to saving stress and time spent in waiting rooms, the Take Command Health membership plan helps those dollars spent on healthcare stretch further. 

Ready to start? You can chat with us on our website or email us at support@takecommandhealth.com

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Hi, I'm Larissa! After graduating with a degree in Public Relations, I decided to start my journey in healthcare management and stayed in the industry for 9 years. Currently, I'm pursuing my masters in counseling while still keeping my hand in the healthcare field with Take Command Health. Most importantly, I'm a single mom to a three-year-old whose goal is to experience all of the emotions every hour of every day.