Get Health Insurance Now! Learn about Special Enrollment Period

Get Health Insurance Now! Learn about Special Enrollment Period!

Although the open enrollment period to buy health insurance ended February 15, 2015, you still have options to buy a policy in time to avoid ObamaCare penalty fees for not having insurance.

What many Americans don’t know is that the health exchanges are operational throughout the year. But getting access to it outside of the open-enrollment period depends on certain unique life circumstances. If you have what public health officials are calling a “qualifying life event,” you then qualify for a special enrollment period.

A special enrollment period refers to a time outside of the annual open enrollment period, when you can buy health insurance through a federal or state health exchange.

The definition of what constitutes "a qualifying life event" is somewhat open ended, but in essence, it refers to any life altering event that makes it harder for you to get health insurance. You will soon learn this includes a broad range of issues.

As you read through some of the examples below, it is important to keep in mind that the duration of your special enrollment period vary depending on your unique circumstance; some may trigger a 120 day enrollment period, while others may be shorter with no exemption. In most cases though, your special enrollment period should last up to 60 days before and 60 days after the date of the incident (month before the incident, month of the incident, and month after the incident).

The following are a few examples of qualifying life events that may trigger special enrollment period:

  • Losing essential health coverage, for you or your family member due to unforeseen circumstances (job loss, divorce, expiration of COBRA, no longer on your parent's plan). Typically special enrollment period will trigger right after you lose coverage, so that there is no lapse in coverage. However, this does not apply to cases where one loses coverage due to failure to pay his or her monthly premiums or when a short-term medical policy expires.
  • A change in your family structure. Marriage, birth, adoption, changes in dependency relationships (you gain a dependent or become dependent) or death of a family member. Pets do not apply, even though many of us consider them family.
  • A change in income or household status, particularly ones that affects your eligibility for premium tax credits, cost-sharing arrangements or subsidies. The ACA has special provisions in place to help Americans with limited income to acquire insurance. These are mostly subsidies provided by the government  based on a sliding income scale--”those who make less, pay less.” So if your income changes to where you current provisions aren’t helpful, for example, your household income decreases by 20%, and you are struggling to make payments, you will get special enrollment to get a new plan with different provisions.
  • A change in one's citizenship status, becoming an American citizen, gaining eligibility to become a citizen or gaining lawful status.
  • You were denied access to a public health program such as Medicaid, CHIP or your local indigent health care program. You need provide proof (documentation) that shows you were denied access to any of the programs.
  • You moved to a new location where your current health policy does not apply or does not provide access to similar quality of services.
  • Experienced government errors, if you failed to apply for a policy because of an erroneous conduct by an official/representative from the Health Exchange or the Department of Health and Human Services. You may need to provide some proof here.
  • Technical challenges, you tried to sign up, but had problems with registering via the website or the call center. You need to attest your story, and may have to provide some kind of proof.
  • Hardship Exemptions , most qualifying life events may also allow you hardship exemptions, in which case you may be exempted from paying penalty fees, have extended time to enroll, or can get catastrophic coverage. The Department of Health and Human Services has identified at least 40 types of hardship exemptions.

If you have further questions about special enrollment period or need help on which health insurance best meets your unique needs, please visit TakeCommandHealth, where we help you shop smarter for health insurance.

Sources: ObamaCare Facts, Healthcare.gov

 

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