Losing Coverage Outside of Open Enrollment

This is horrible! i hate obama care! My 7 children and I had healthcare but my husband changed jobs and one messed up the timing to get him insurance. So what do we pay 1% for him not having insurance!? we all suffer! he never even needed a dr. all year!
How stupid! Government is too big!

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I cannot believe I even voted for Obama. I need substance abuse treatment coverage so I can live a healthy life. Outside of open enrollment it is impossible to get the coverage I need at any price unless I quit both of my jobs and become eligible for Medicaid or meet one of the qualifying events. Even if I buy a policy November 1st when enrollment starts the coverage won’t begin until January 1st of 2017. They penalize you for not having coverage but make it impossible to get coverage if you don’t have the means to during open enrollment. It makes no sense at all. The ACA is the most absurd contradicting bill Congress has passed. It’s so frustrating when you are trying to live a better life but run into a wall every way you go bc the government has to control and regulate when one can get the coverage they need. I need help. I need coverage to get help. I can’t get coverage until the government says so…. I know I’m in the predicament I’m in bc of my own actions with substance but I’m trying every possible thing I can to get help but the government doesn’t think I need help until their enrollment starts. I can’t wait that long. What if you can’t afford anything during open enrollment? Then they charge you out of your taxes for being too broke to get healthcare bc when you could afford it you couldn’t get it bc open enrollment is over. Why do you only have a few months window to get good coverage. Whats the difference between getting it then or getting it now?? I’m sorry for the length of this comment I just had a lot to say. The Affordable Care Act is by no means affordable and it shouldn’t be called Obamacare bc the ppl who put it in place do not care at all. It’s about control and money and I’m sick of it. I just want healthcare that I can use to help me get well. Apparently i don’t qualify. I should have voted for Romney.

Michelle Atherden

My daughter has health insurance through her job. She is going to cut back to part time so she can increase her hours in her college courses. She will lose her health insurance coverage when this happens. What are her options?


Sorry to hear about this experience. If you lose coverage outside of open enrollment you have a few options under the ACA. You can enroll in the new employer plan, if that doesn’t start soon enough, you can take advantage of qualifying for a special enrollment period, and you also have options like COBRA. The law gave you lots of options, but open enrollment periods can be complex, and it makes sense that your husband missed his window of opportunity. So here are some things to understand.

– He probably could have qualified for marketplace special enrollment by explaining the situation, even if he missed the 60 day window that started at the time he lost his coverage.
– Health insurance, especially for a family, isn’t just about how often you use it, it’s about knowing you are covered in an emergency and getting routine essential care. With such a large family, risking bankruptcy if your husband gets sick is never the best bet. With new limits on annual and lifetime care for essential benefits and caps on out-of-pocket maximums, you are always protected in an emergency.
– Considering he didn’t use a doc much, he could have simply went with the cheapest coverage option and taken advantage of the free annual wellness visits and preventive services. When he did have a medical expense he would pay your insurer rates, and again in a worse-case your family and your bank account are protected.
– The fee is for each month you go without coverage (not the whole year), so the months you did have coverage, plus a 3 month consecutive period you didn’t have coverage are exempt. Therefore the fee may be less than you a projecting. If he didn’t have coverage all year it is 1% divided 12 months, then that monthly fee is paid per full month without coverage.
– It’s tempting to blame the ACA for everything health insurance, but the truth is even before the ACA you’d still have to navigate coverage and switching jobs.

The above being said, he may actually have a solution for 2014. He can apply for a hardship exemption, as losing coverage and not being able to find a plan may count as a hardship. Make sure to do that through HealthCare.Gov with enough time to sort things out before tax season. Both hardship exemptions 13 and 14 may apply to your situation. In both cases you’ll probably need copies of your cancellation letter. They have a help line that can assist you.

Good luck, and make sure everyone’s coverage is in place during open enrollment, no matter how you get it for this year.


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