Nov. 15 begins next health insurance buying opportunity...unless this happens

By Posted : 04/10/2014

Obamacare Over CompassThe deadline for buying an individual health insurance plan for this year for most people was March 31, but if you meet certain criteria, you can still purchase coverage for 2014.

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An individual plan can cover just one person or a family and can be purchased directly from a health insurance company or from the online health insurance exchange run by your state or by the federal government.

Open enrollment ended March 31, though it was extended to April 15 for those who began the application process before the deadline but could not complete it. Open enrollment for 2015 health insurance plans is Nov. 15, 2014, through Feb. 15, 2015.

Outside the state and federal exchanges, the health care reform law lets insurers sell health plans beyond the annual open enrollment period. In most states, though, insurers are choosing to limit sales to that time-frame. Insurance companies don't want consumers to wait until they get sick to buy coverage. Nevada is the only state so far requiring insurers that sell plans outside the state's marketplace to offer those plans year-round.

Qualifying life events allow you to buy health insurance after enrollment deadline

If you missed the March 31 deadline to purchase coverage for 2014, you can enroll only if you have a special circumstance, known as a "qualifying life event." In most cases you have 60 days after the event to enroll. These events include:

  • Getting married.
  • Having or adopting a child.
  • Permanently moving to a new area that offers different health plans.
  • Losing other health coverage because of job loss, divorce, loss of eligibility for Medicaid or the Children's Health Insurance Program, expiration of COBRA coverage or if your health plan no longer meets federal and state standards for minimum coverage. (Losing coverage because you didn't pay the premiums does not qualify you for special enrollment.)
  • A change in your household that affects eligibility for tax credits or cost-sharing subsidies, if you're already enrolled in a marketplace plan.

There are also other "complicated cases" that may qualify for an extended enrollment period, according to the federal health care reform website. Here is a partial list; check healthcare.gov for details:

  • You have a serious medical condition that, for example, results in unexpected hospitalization or temporary cognitive disability.
  • You experience a natural disaster that kept you from enrolling. Examples include an earthquake, hurricane or severe flooding.
  • Misconduct or misrepresentation by an insurance company, navigator, certified application counselor, or agent or broker resulted in you not getting enrolled in a plan, being enrolled in the wrong plan or not getting the premium tax credit or cost-sharing reduction you were eligible to receive.
  • Certain cases involving enrollment errors due to inaccurate data.
  • If your immigration status was changed due to errors during the application process.
  • Display errors on HealthCare.gov: Incorrect plan data was displayed at the time that you selected your health plan, such as benefit or cost-sharing information. This includes issues where some consumers were allowed to enroll in plans offered in a different area, or enroll in plans that don't allow certain categories of family relationships to enroll together.
  • If you applied for Medicaid through your state, or were sent to Medicaid from the exchange, but you weren't eligible for Medicaid.  Another example -- your state transferred your information to the exchange but you didn't get an answer about your eligibility and/or didn’t get enrolled before March 31.
  • Your application was stopped due to specific error messages. For example, you received a "data sources down" error message or another error message that didn’t allow you to enroll.
  • Certain cases for victims of domestic abuse.

 

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