Friday, September 19, 2014
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You Can Still Get Health Care Coverage This Year, Even if You Missed the Exchange Deadline

The Obama administration announced that 7.1 million Americans obtained individual health insurance coverage through the marketplace exchanges by the March 31st deadline. However, if you missed the deadline, you are not out of luck. You still have four options for getting coverage in 2014.

You Can Still Get Health Care Coverage This Year, Even if You Missed the Exchange Deadline

The federal health-care website. (AP Photo/Jon Elswick, File)
The federal health-care website. (AP Photo/Jon Elswick, File)

The Obama administration announced that 7.1 million Americans obtained individual health insurance coverage through the marketplace exchanges by the March 31st deadline.  However, if you missed the deadline, you are not out of luck.  You still have four options for getting coverage in 2014.

You can still apply for a policy if one of the following applies to you:

1. You tried to get insurance through an exchange but couldn’t complete the application

The online marketplaces have had countless problems since they launched.  The federal exchange was even taken temporarily offline on Monday as people flooded the site.  As a result, those who started the process before March 31st will be given until April 7th to complete a paper application or until April 15th to complete an online application. 

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If you use this option, coverage will start on May 1st and you won’t pay a penalty for not having coverage for more than three months during the year.

2. You experience a “qualifying life event” at any time during the year

Although the open enrollment periods will be limited to a few months each fall and winter (November 15th – February 15th), there are a series of triggering events that create the chance to get coverage between them.  Major life events, such as getting married, changing jobs, or becoming a parent qualify individuals to sign up when the event occurs.

If you have a major life event, be sure to act quickly.  You only have 60 days from the date of the event to enroll.  If you don’t obtain coverage by then, you may be subject to a penalty if you go uncovered for more than three months during the year.

3. You qualify for Medicaid or the Children’s Health Insurance Program (CHIP)

The open enrollment restriction only applies to those who want to enroll through an exchange.  If your family size and income qualify you for Medical Assistance in your state (check here to see if you qualify), then you don’t have to wait to get covered.

If you live in Pennsylvania, which has not expanded Medicaid, and fail to qualify for either Medicaid or a subsidy for an exchange policy because your income is below 100% of the federal poverty level, you won’t be subject to the penalty for not obtaining coverage.

4. You buy insurance directly

Individuals who missed the open enrollment deadline can always buy a policy directly from an insurance company.  Federal subsidies for coverage won’t be available, but insurers are still bound by other parts of the law, such as having to cover those with pre-existing medical conditions.

If you choose this route, watch out for short-term plans or plans that don’t meet federal guidelines—if you get one, you could still end up paying a penalty for not being covered. 

If none of these options apply to you, open enrollment for 2015 begins on November 15 and runs through February 15, 2015.

Krystyna Dereszowska A third-year law student concentrating in health at Drexel
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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