If you've missed the open enrollment window to sign up for an ACA-compliant health plan through the Health Insurance Marketplace, all hope is not lost. You still have several options to get coverage for the year. Take these steps to find a plan that will work for your needs, no matter the time of the year.
If you do not have insurance coverage and you need it in a hurry, one of the first places to look is short-term medical coverage. While these types of plans are not compliant with the Affordable Care Act (ACA), and therefore would not allow you to avoid the tax penalty, they do provide coverage for unexpected illness or injury.
Short-term insurance is ideal for bridging your coverage gap while you're securing a new health plan, but keep in mind that it is a complement to an ACA-compliant plan- not a substitute.
Qualifying Life Event
If you go through a major life change, such as getting married, having or adopting a child, or changing jobs, you may qualify for a special enrollment period. For 60 days after any qualifying life event, you are able to enroll in a health plan through the Marketplace, even outside the open enrollment period.
Other qualifying life events include the following:
- Moving to a new state
- Losing prior health coverage due to divorce or changing jobs
- A material change in income that affects the coverage you qualify for
- Becoming a United States citizen
- Leaving incarceration
- A change in dependency status of someone on your plan
- Death of a household member
- Gaining membership in a federally recognized American Indian tribe
- Turning 26 years old
- Ending your service in AmeriCorps
If you qualify, head to Healthcare.gov to learn more.
Major Medical Plans Available Year Round
If you do not qualify for a special enrollment period, you can still purchase coverage outside of the government-sponsored marketplace. You can purchase insurance directly from an insurance company any time of the year. While you will not get any tax credits or savings based on income, you may be able to find an ACA-compliant plan outside of the Marketplace. Keep in mind, however, that your options for ACA-compliant plans are much more limited outside of open enrollment.
To find a plan, you can use the Healthcare.gov Plan Finder. Once you find a plan you like, call the insurance company directly for information on applying. If you know of a plan or insurer you already prefer, you can contact that insurer directly.
Need additional help getting started? Review this list of four options to find an ACA health plan.
Remember the Tax Penalty
Under the Affordable Care Act, you will owe a fee for any month you, your spouse, or your tax dependents don't have an ACA-compliant health insurance plan. The fee, sometimes referred to as the "tax penalty" or "individual mandate," is paid when you file your federal tax return. You can avoid this fee by claiming a "short gap in coverage" exemption if you go without ACA-compliant coverage for no more than 2 consecutive months.
The fee for foregoing coverage is the higher of 2.5% of your household income or the per person fee of $695 per adult and $347.50 per child under 18 years old. Under the percentage of income calculation, the maximum penalty is equal to the total yearly premium for the national average price of a Bronze plan sold through the Marketplace. For more details, see Affordable Care Act fees.
Living without insurance for a few months will leave you with a tax penalty. If you have yet to obtain health insurance for 2016, there is no better time to apply than today.