Deadlines - Enrollment Periods

You can no longer get health insurance anytime you want. You are now required to get insurance only during the OPEN ENROLLMENT PERIOD. The next one is:

  • 2018   -->  November 1, 2017  -  December 15, 2017

On top, there's also a waiting period of 15-30 days before your policy becomes effective and it depends on when the application was submitted.

The only other time you can get health insurance is during the SPECIAL ENROLLMENT PERIOD. A time outside of the open enrollment period which you and your family have a right to sign up for health coverage, is if you experience a Qualifying Life Event (QLE).

What is a QUALIFYING LIFE EVENT? A qualifying life event is a circumstance, generally outside of your control, that causes such a big change in your life that you are allowed a special enrollment period for your insurance. Such as:

  • marriage or divorce
  • change in the number of dependents (birth or death)
  • change in job status
  • dependent who gains or loses health insurance
  • gaining, losing, or changing coverage due to government error
  • increasing or decreasing your income enough that your subsidy eligibility changes
  • moving to a new coverage area

 What if you don't qualify in either Enrollment Periods? Check if a Short Term or Fixed Benefit plan is an option for you. Go to Individuals/Families

 

Penalties

If you decide to go without Health Insurance, the penalties are as follows:

  • 2014 = $95 per adult and $47.50 per child (up to $285 for a family) or 1% of family income, whichever is greater
  • 2015 = $325 per adult and $162.50 per child (up to $975 for a family) or 2% of family income, whichever is greater
  • 2016 & beyond = $695 per adult and $347.50 per child (up to $2,085 for a family) or 2.5% of family income, whichever is greater

To get a more accurate estimate of your tax penalty, go to: Tax Penalty Calculator

 

Rules - Everyone is Now Required to Have Health Insurance

Under certain circumstances, you won’t have to make the individual responsibility payment. This is called an “exemption.”

You may qualify for an Exemption if:

  • You’re uninsured for less than 3 months of the year
  • The lowest-priced coverage available to you would cost more than 8% of your household income
  • You don’t have to file a tax return because your income is too low
  • You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider
  • You’re a member of a recognized health care sharing ministry
  • You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare
  • You’re incarcerated, and not awaiting the disposition of charges against you
  • You’re not lawfully present in the U.S.

 You may also qualify for Hardship Exemption if:

  1. You were homeless.
  2. You were evicted in the past 6 months or were facing eviction or foreclosure.
  3. You received a shut-off notice from a utility company.
  4. You recently experienced domestic violence.
  5. You recently experienced the death of a close family member.
  6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  7. You filed for bankruptcy in the last 6 months.
  8. You had medical expenses you couldn’t pay in the last 24 months.
  9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
  10. You expect to claim a child as a tax dependent who’s been denied coverage in Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you do not have the pay the penalty for the child.
  11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace.
  12. You were determined ineligible for Medicaid because your state didn’t expand eligibility for Medicaid under the Affordable Care Act.
  13. Your individual insurance plan was cancelled and you believe other Marketplace plans are unaffordable.

What if you don't qualify for any Exemptions? What are your options? Go to Individuals/Families