If you miss the deadline for health insurance, you may still be able to get coverage. Here are your options:
Special Enrollment Period
You may still be able to sign up for a health plan if you have something called a “qualifying life event” that would make you eligible for a special enrollment period.
Here are some common qualifying life events:
- Having a baby, adopting a child, or placing a child for adoption. Coverage can take effect the day of the event, and the enrollment window is open up to 60 days afterwards.
- Getting married. Getting wed can make you eligible for a special enrollment period, which will take effect the first day of the month after you enroll. In this instance, your enrollment window is open for up to 60 days after your marriage (you can’t enroll until getting married!)
- Losing other health coverage. If you lost your previous coverage after the cutoff, you may be able to qualify for special enrollment. This could include losing a job-based plan, aging off a parent’s coverage at age 26, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and other similar events. Coverage can take effect the first day of the month after you enroll and after the loss of coverage. Make note that the enrollment window runs from 60 days before to 60 days after losing your other coverage. (Losing a health plan due to non-payment of premiums does not qualify as losing health coverage. So if you’re planning on leaving your full-time job to go freelance, you can buy health insurance when you leave your job.
- Being denied Medicaid or CHIP coverage. Medicaid and CHIP are nationwide programs that provide coverage to people with low incomes or disabilities -- for both of these programs, you can apply anytime. If you are denied Medicaid or CHIP coverage, you may be eligible to enroll in a health insurance plan up to 60 days after the denial. Coverage can take effect the first day of the month after you enroll.
- Major income changes. If you lose a huge client and are already enrolled in a health plan, you may re-apply for subsidies or get higher subsidies. Just note that you can’t apply for a new plan or change plans; you can only change your subsidy amount. But you can also become ineligible for subsidies if you made more income than you expected!
- Moving. You may be eligible for a special enrollment period if you move and your relocation affects your rate because you moved into a different rating region. You may also qualify if your move affects your plan options, for instance if you move out of the service area for one carrier and into the service area for another, or if you move to another state.
Other qualifying life events
In addition to the situations listed above, there are a number of other life events that could qualify you for a special enrollment period. Visit healthcare.gov’s list of events to see if you can obtain coverage.
Qualifying for Special Enrollment due to a “Complex Situation”
You may still be able to obtain coverage if a “complex situation” prevented you from enrolling before the deadline. This could include an unexpected hospitalization, a natural disaster, or enrollment error that prevented you from obtaining coverage before the deadline. See if you qualify here.
Are you ineligible for special enrollment? About that fee…
If you don’t qualify for special enrollment, then you probably can’t get health coverage until the next open enrollment period, scheduled for November 15, 2015.
Without health coverage, you’ll have to pay a fee (2% of your income or $325 per adult, whichever is higher) or get a fee exemption. There are several scenarios that may qualify you for a fee exemption -- for example, if you didn’t have minimum essential coverage for all or part of 2014. HealthCare.gov has a detailed list of fee exemptions, as well as instructions on how to apply for an exemption.
If you think you qualify for a special enrollment period, you can apply for coverage provided through Freelancers Union, or you can contact the Marketplace Call Center at 1-800-318-2596 or visit HealthCare.gov.
Do you have any more health coverage questions? We’re here to help!