Obamacare News Blog

What if You Miss the Healthcare Exchange Initial Enrollment?

The Patient Protection and Affordable Care Act’s, AKA ObamaCare, Healthcare Exchange’s open enrollment period begins Oct. 1, 2013, and extends through March 31, 2014, but what happens if you miss this period? We’ve found which exemptions qualify you to avoid federal penalties and to be able to sign up after the initial period to ensure your coverage.The new Healthcare Exchange “metal” plans are Bronze, Silver, Gold, and Platinum.

healthcare-exchange-initial-enrollment

If You Don’t Enroll During the Initial Period You Can Enroll if Circumstances are Triggered by One of the Following Events:

  • A qualified individual and/or any dependents losing previous minimum essential coverage.
  • A qualified individual gaining or becoming a dependent through marriage, birth, adoption or placement for adoption.
  • A new citizen or one obtaining national or lawful presence in the United States.
  • A mistake made during enrollment.
  • An individual enrolled is able to prove that the Qualified Health Plan, in which he or she is enrolled, substantially violated a material provision of its contract.
  • A change of income, making an individual either newly eligible or ineligible for federal premium subsidies or federal cost-sharing subsidies.
  • An individual makes a permanent move in which they are eligible for new Qualified Health Plans.
  • Circumstances that Are Not Allowable for Exemption

  • Loss of coverage does not include failure to pay premiums on a timely basis.
  • Not paying COBRA premiums prior to expiration of COBRA coverage
  • How Much Time You Have to Enroll in this Special Enrollment Period

    An individual has 60 days from the date of a triggering event to select and enroll in a plan. Small business and group market have 30 days to enroll in the Special Enrollment Period.

    Next Steps:
    Any further questions about the Healthcare Exchange please call 800-930-7956 or contact Medicoverage.



    Comments and Questions

    Click to leave a Comment

    Comment from cs on October 01, 2013

    You didn’t answer the question.  What if you miss the enrollment period?  When can you enroll?  Are the dates the same every year?

    MEDICOVERAGE AGENT RESPONSE
    CS,
    Sorry the article wasn’t clear. If you miss the open enrollment period due to the special circumstances discussed in the article, you are able to enroll within 60 days.

    If you miss the open enrollment period WITHOUT special circumstances, however, our understanding is that you will not be able to enroll in Exchange plans till the next open enrollment period and you may pay a penality. For subsequent years the open enrollment is October 1 - December 7.

    We have also been told that you may also apply for an Off-Exchange all year long. These plans should be similar to On Exchange plans but with no offer of federal subsidies. At this time we don’t know all the details of the Off-Exchange plans but you might still have to pay a prorated penalty if you wait too long with no coverage. So it is best that you enroll during the open enrollment.  Call us at 800-930-7956 to discuss your options.
    -Chris from Medicoverage.com



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