What Happens if I Missed the Deadline for ObamaCare?
If you miss the annual deadline for ObamaCare Open Enrollment, you still have options for obtaining health insurance.
Options for getting covered outside of open enrollment include qualifying for a special enrollment period (which can extend the time you can use the marketplace), Medicaid, CHIP, short-term health insurance, and other insurance types.
What “missing the ObamaCare deadline” means is subject to change depending on the time of year and other contexts (like here in 2017 with President Trump and a repeal and replace plan in the works).
We’ll be discussing what to do if you missed this year’s open enrollment period for the individual and family private market, but other information about other deadlines will be posted as well. So read carefully.
UPDATE FOR OPEN ENROLLMENT 2017: For 2017, with repeal and replace on the way, there has been no official ObamaCare enrollment extension announced. If you started the enrollment process and didn’t finish you may have leeway, and state marketplace may offer leeway, but officially HealthCare.Gov is closed for business (outside of special enrollment and account management) until further notice.
UPDATE FOR OPEN ENROLLMENT in 2016: 42 states extended the December 15th, 2016 deadline to December 17th or 19th, 2016. If you missed the December 15th deadline, here are a few things to know. Open enrollment 2017 ends on January 31st, 2017. Last year the deadline was extended to the 17th – 19th in some states (and this is true again this year for 42 states). If you enroll in coverage before the 15th of a given month of open enrollment, coverage starts by the 1st of the next month. If you enroll after coverage starts, your coverage will begin on the 1st of the month after. Thus, those who enroll at the last minute in January will have coverage that starts March 1st. Luckily we all get a “short coverage gap” exemption. “Missing the December 15th deadline” means “your coverage won’t start until February 1st.” Need to do this quick? We suggest an HSA eligible silver plan as a rule of thumb (get more tips for health plans here). Remember to sign up and enroll; just signing up isn’t enough.
What to Do if You Missed The 2016 ObamaCare
If you missed the annual ObamaCare deadline of January 31, 2016 [last year’s deadline, not this year, we will update the page once open enrollment 2017 ends on January 31st, 2017], you’ll no longer be able to get Minimum Essential Coverage in the individual and family market for 2016. This is true both inside and outside the Marketplace. Luckily there are some ways around this.
Here is what you need to know if you missed the 2016 deadline [much of this will apply to 2017, so feel free to read from that perspective]:
- You will owe the fee for each month you go without coverage or an exemption in 2016. The only way around this is to qualify for a special enrollment period due to qualifying life events, Medicaid, or CHIP.
- Some states have extended the deadline for those who signed up but didn’t finish enrolling in a plan for 2016. Extensions are different for each state, and it seems HealthCare.Gov has not announced an extension. Notice that we have fairly accurately predicted extensions for the past three years by looking at the crossed out text.
We don’t know what will happen this year. The following crossed out information is what happened last year. There is an Extra ObamaCare Enrollment Period for 2015 for those who owed the fee from 2014. This special enrollment period goes from March 15th – April 30th for 2015 only. An ObamaCare extension may be announced granting Americans who missed the deadline an extra open enrollment period around the tax season. This is a rumor; there has been no official announcement.
- Those who, for any reason, had trouble signing up may qualify for a short special enrollment period.
- Those who got rejected for Medicaid or CHIP may qualify for a special enrollment period. You can enroll in Medicaid and CHIP 365 days a year.
- Short Term Health Insurance can be obtained outside of the marketplace through an Insurance Agent, broker, or provider outside of open enrollment. However, short term won’t protect you from the fee.
- Insurance types like Medicare and employer coverage have unique enrollment periods.
- If you missed the deadline for 2016, you should look into all of your health insurance options and possible exemptions.
- There are over 40 different qualifying life events and exemptions to look into.
- Consider Short Term to protect your health in the meantime. Consider special enrollment and exemptions to protect you from the fee and to help expand your coverage options.
If you missed your state’s extension deadline, don’t worry. Most states extended a special enrollment period until April 30th, 2015. Learn about the “extra enrollment period” for those who don’t have coverage and are facing the fee.
When Is the ObamaCare Deadline?
- The deadline for ObamaCare open enrollment 2014 was March 15th, 2014.
- The deadline for ObamaCare open enrollment 2015 was February 15th, 2015.
- The deadline for ObamaCare open enrollment 2016 was January 31, 2016.
- Moving forward the deadline for ObamaCare open enrollment may change. However, the proposed “normal” deadline will be December 15th of each year.
- Remember deadlines apply to all private coverage in the individual and family market, both inside and Outside The Marketplace.
No matter how you plan to get private coverage for you or your family, you need to sign up before open enrollment ends!
Most health insurance types, like employer-sponsored coverage and Medicare, have unique open enrollment periods, while some forms of health insurance, like short term and Medicaid, can be obtained at any time of the year.
Missing the Deadline For Coverage Starting January 1st
The deadline to get a plan that starts on January 1st is December 15th each year. If you have a marketplace plan from the year before, make sure to verify your information and plan before December 15th to ensure you get the right plan and cost assistance. If you miss that deadline, make sure to verify your info before open enrollment ends.
From the start of open enrollment to December 15th each year, you can enroll, switch plans, and verify cost assistance. If you miss that deadline, you won’t have a plan that starts by January 1st. Since a lot of your out-of-pocket costs are based on policy periods, it makes little sense to not have a plan for the full year.
In some states, you have until December 23rd to enroll in a plan for the 1st. In other states and HealthCare.Gov, plans typically renew by December 19th. If you are still in that window, do yourself a favor and sign into your marketplace account to make sure that everything is in order. If you are outside of that window and still within open enrollment, you can still enroll, switch plans, and verify cost assistance.
Coverage obtained before the 15th starts the 1st of the next month after you pay your premium.
FACT: All marketplace plans end on December 31st unless otherwise noted. Remember that out-of-pocket cost sharing limits like deductibles and out-of-pocket maximums are based on policy periods, so make sure to start your plan on time to get the most out of your health plan.
Buying a Plan Outside of Open Enrollment
Unless you qualify for special enrollment in the health insurance marketplace, if you miss the ObamaCare deadline for open enrollment, you’ll end up shopping for private Individual and Family coverage outside of the Marketplace.
The selection of Private Health Plans offered to individuals and families will be limited to mostly short-term plans post open enrollment since insurers, for the most part, won’t offer ACA-compliant plans outside of open enrollment.
Short-term plans don’t have to follow the rules and regulations of ACA-compliant plans and won’t help you avoid the fee for not having health insurance; however, they will help cover your healthcare costs and needs. Short-term plans, on the plus side, are almost always less expensive than unsubsidized private health plans and tend to have no waiting periods.
FACT: Those who have been ignoring the requirement to obtain and maintain coverage risk finding out how they’re affected for the first time during the 2015 tax season. Since taxes are due April 15th and Open Enrollment ends February 15th, it creates a gap in which some will want coverage but will not be able to get a plan that starts before January 1st, 2016. Learn more about why you should get health insurance.
ObamaCare Deadline, Fee, and Extensions
If you missed the ObamaCare enrollment deadline, you would incur a fee for each month you go without health coverage (or exemption), and you will not be eligible for cost assistance or marketplace insurance (unless you qualify for an extension). You won’t be able to get Marketplace coverage outside of open enrollment unless you qualify for a special enrollment period, but like last year, you still have options.
You can enroll during each year’s open enrollment period. In 2015 open enrollment was from November 15th, 2014 to February 15th, 2015. Outside of open enrollment, you have options, but they are limited.
Let’s take a look at some scenarios and figure out what extensions and exemptions are available and what health insurance options folks who missed the ObamaCare enrollment deadline have while they wait for the next open enrollment period.
To avoid the penalty in 2014, you needed to have coverage that started by May 1st, 2014. For 2015 you needed to enroll by February 15, 2015. Insurance purchased before the 15th of each month starts on the first of the following month after you have paid your premium.
ObamaCare Deadline Extension
There was an ObamaCare deadline extension (this was a one-time exemption – not the ongoing special enrollment period) for folks who signed up for the health insurance marketplace but were unable to enroll in a plan by the March 31, 2014, deadline.
By checking a box upon logging in after April 1st, you were able to enroll in a plan until about mid-April. After mid-April, you were still able to qualify for an extension under special circumstances.
There was a similar extension in 2015 allowing folks who signed up until February 22nd to complete enrollment.
To enroll in ObamaCare’s marketplace after the open enrollment deadline, you can:
- Log in to your online Marketplace application on HealthCare.gov and finish the enrollment process – you’ll just need to confirm online that you were still trying to enroll on March 31st.
- Or contact the Marketplace Call Center at 1-800-318-2596. The Call Center can help you complete your enrollment over the phone. TTY users should call 1-855-889-4325. Be sure to tell the customer service representative that you’ve been trying to enroll.
ObamaCare Missed Deadline 2014
If you missed the ObamaCare sign up deadline of February 15, 2014, it’s OK. You could still enroll in a health insurance plan anytime before March 31st, 2014 due to a special enrollment period that applied to everyone.
If you have signed up for the marketplace but were unable to enroll by March 31, you had until about mid-April to finish the enrollment process due to an extension.
If you still didn’t enroll in a plan by that deadline, your options included qualifying for a special enrollment period, purchasing short term health insurance outside of the marketplace, qualifying for another insurance type, paying the per month fee for not having coverage, or qualifying for an exemption from the fee.
Remember that signing up and enrolling are two different things. You needed to enroll before the ObamaCare deadline to be considered covered.
Can I Still Get Subsidies if I Missed the ObamaCare Deadline?
If you miss the annual deadline to sign up for ObamaCare, you’ll have to wait until next year’s open enrollment to get subsidized health insurance through the marketplace unless you qualify for a special enrollment period. Please note: Americans who sign up for the marketplaces before the deadline but, for any reason, have trouble enrolling in a plan will qualify for a special extension that gives them a little extra time to enroll and can extend the time they were exempt from the fee.
You can’t get cost assistance unless you have a Marketplace plan, and you can’t get Marketplace plans outside of open enrollment.
ObamaCare Special Enrollment Period
A special enrollment period is a time outside of the open enrollment period when you and your family can sign up for health insurance. You may qualify for a special enrollment period of 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage.
If you don’t have a special enrollment period, you can’t buy insurance inside or outside the Marketplace until the next open enrollment period. Job-based plans allow for special enrollment periods of 30 days.
Some special enrollment periods are longer or shorter, so check the enrollment period’s length when you qualify.
The following life events will generally qualify you for a special enrollment period.
- You signed up for the marketplace but, for any reason, were unable to complete the enrollment process (until mid-April 2014).
- Getting married.
- Having, adopting, or placement of a child.
- Permanently moving to a new area that offers different health plan options.
- Losing other health coverage (for example, due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or the decertification of your health plan). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums do not qualify as loss of coverage. Losing coverage that is not minimum essential coverage is also not considered a loss of coverage.)
- For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions.
- An individual who was not previously a citizen, national, or lawfully present individual gains such status.
- A qualified individual’s enrollment or non-enrollment in a QHP is unintentional, inadvertent, or erroneous and is the result of the error, misrepresentation, or inaction of an officer, employee, or agent of the Exchange or HHS, or its instrumentalities as evaluated and determined by the Exchange.
- An enrollee adequately demonstrates to the Exchange that the QHP in which he or she is enrolled substantially violated a material provision of its contract in relation to the enrollee.
- An individual is determined newly eligible or newly ineligible for advance payments of the premium tax credit or has a change in eligibility for cost-sharing reductions, regardless of whether such individual is already enrolled in a QHP. The Exchange must permit individuals whose existing coverage through an eligible employer-sponsored plan will no longer be affordable or provide minimum value for his or her employer’s upcoming plan year to access this special enrollment period prior to the end of his or her coverage through such eligible employer-sponsored plan.
- An Indian, as defined by section 4 of the Indian Health Care Improvement Act, may enroll in a QHP or change from one QHP to another one time per month.
- A qualified individual or enrollee demonstrates to the Exchange, in accordance with guidelines issued by HHS, that the individual meets other exceptional circumstances as the Exchange may provide.
See our special enrollment section for more details.
I Don’t Qualify For Special Enrollment, What Other Health Insurance Options Do I Have?
If you don’t qualify for special enrollment, you still have health insurance options. If you qualify for Medicaid or CHIP, you can sign up at any time although you’ll have to use alternative sign up methods for Medicaid and CHIP as you will not be able to sign up through the marketplace. If you don’t qualify for subsidized insurance or public health options, your best course of action will be to simply speak to an agent or provider and purchase private insurance outside of the marketplace. While many insurance options outside of open enrollment aren’t ACA compliant and won’t help you avoid the fee, they can help you cover your medical costs and needs.
NOTE: If you sign up for insurance after open enrollment, you will owe 1/12th of the yearly fee for not having insurance for each month you go without coverage. This is true regardless of how or when you obtain insurance.
What If I Don’t Obtain Health Insurance?
The Affordable Care Act doesn’t force you to purchase health insurance, but it does mandate that you pay a fee if you choose to go without health coverage. If you don’t obtain health insurance during open enrollment each year, you will owe 1/12th of the yearly fee for each month you go without coverage. Learn more about the individual mandate.
What Happens If I Miss the Deadline to Enroll in ObamaCare?