Thought Feb. 15 was your last chance to sign up for insurance through the Affordable Care Act? Well, not exactly…
Although the deadline for the open enrollment period is over for most people, there are still some options for getting health insurance coverage, according to industry experts.
“You still do have options,” said Rick Welsh, president of Welsh and Associates, a Kansas City-based health care and insurance consulting business that works with OOIDA’s Medical Benefits Group. “You can get some sort of protection on a temporary policy to fill in the gap until Jan. 1, 2016.”
Welsh said the benefit of a temporary insurance policy is it will help cover any medical costs between now and the start of 2016. But he said the plans “will not keep you out of the penalty box” come tax time.
Welsh said some of the major medical conditions that would likely disqualify an applicant for temporary coverage include heart attack, stroke or cancer.
Outside of open enrollment, the only other way to qualify for a plan is if you have a qualifying event. These events include, but are not limited to, marriage, divorce, loss of minimum essential coverage, and permanent move to another state.
While short-term policies and supplemental plans will not prevent the assessment of a tax penalty, OOIDA Medical Benefits Manager Brenda Smith said those short-term policies can at least provide coverage for certain medical events and emergencies.
Smith said that if you aren’t going to purchase any insurance in 2015, at least consider preparing to purchase coverage for 2016.
“Do not wait until the last minute,” she said. “The open enrollment for 2016 effective dates will be even shorter. Those enrollment dates are Oct. 15, 2015, to Dec. 7, 2015.”
An extension issued by the White House last March allows people with health insurance plans that don’t comply with Affordable Care Act standards to keep them through October 2017 if their states allow it.
If you are not already enrolled in a public or private health care plan or do not have health insurance through an employer-provided plan or are not a U.S. military veteran enrolled in VA healthcare, you must be enrolled in a qualified health care plan by the deadline, or pay a tax penalty.
The temporary policies also do not absolve the tax penalty the IRS will assess to those who by law are required to get insurance. Exemptions from the penalty include:
- Being uninsured for less than three months of the year.
- You don’t have to file taxes because your income is too low.
- Membership in a recognized religious sect with religious objections to insurance, including Social Security and Medicare.
- The lowest-priced coverage available to you would cost more than 8 percent of your household income.
- Membership in a federally recognized tribe or eligible for services through an Indian Health Services provider.
There are also a number of “hardship” exemptions, including filing for bankruptcy in the previous six months, or if you were determined ineligible for Medicaid because your state didn’t expand eligibility under the Affordable Care Act. For a complete list of exemptions and more information on how to apply, visit healthcare.gov/exemptions.
The penalty for not having insurance in 2015 is double what it was in 2014. You can now expect to pay up to 2 percent of your household income for failure to comply. Penalties are scheduled to increase again in 2016, and will thereafter be indexed to inflation.
The penalty for being without insurance is calculated on a monthly basis. So if you have a qualifying event and get insurance later in the year and are without insurance for only six months, for example, you will owe half of the penalty.
For more information contact OOIDA’s Medical Benefits Group. Agents are available from 7:30 a.m. to 5:30 p.m. Central time, Monday through Friday, at 800-715-9369 or via e-mail at firstname.lastname@example.org.
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