ObamaCare Extra Enrollment 2015 March 15 – April 30
An extra enrollment period for ObamaCare will take place from March 15 – April 30, 2015. This is a special enrollment period for people who owe the ObamaCare tax for 2014 and were confused about enrollment for 2015. It provides an extra enrollment opportunity to avoid the fee for the rest of 2015.
Here is what you need to know about the 2015 Extra ObamaCare enrollment period for those without coverage:
- Open Enrollment officially ended February 15th, 2015, however, those who had trouble enrolling got a little extra time.
- The 2015 extra enrollment period starts March 15th, 2015 and ends April 30th, 2015.
- The extra enrollment period is meant to give those without coverage an opportunity to avoid the bulk of the fee for 2015.
- Those who don’t have a plan for 2015 yet will still owe the fee for months they don’t have coverage, or an exemption.
- The only time you can get cost assistance is during open enrollment (or during a special enrollment periods like the March to April extra enrollment period).
- Medicaid and CHIP are offered year round. Find out what to do if you got denied Medicaid or CHIP.
- Other ObamaCare extensions existed for 2014.
You may qualify for the extra enrollment period if:
- You aren’t currently enrolled in coverage through the Health Insurance Marketplace for 2015,
- You paid the fee with your 2014 federal income tax return, for not having health coverage in 2014, and
- You were confused or didn’t know about open enrollment dates for 2015 coverage, and need another opportunity to enroll in coverage for the remainder of 2015.
More information on this one time ObamaCare special enrollment period can be found at HealthCare.Gov.
Why is there an Extra Enrollment Period for ObamaCare in 2015?
The additional enrollment period for 2015 is a reaction to the fact that there are still many who are confused about the law. One of the main points of confusion is about how the fee works. The first time many will realize exactly how the fee works is when they file their 2014 taxes before the April 15th tax deadline.
Instead of having a bunch of people wanting coverage, but realizing that they will face the fee again in 2015 for not having it, officials have decided to offer a special enrollment opportunity.
Special enrollment periods, and the qualifying life events that trigger them, are built into the law. So aside from all the normal qualifying life events that trigger special enrollment periods, more will likely be added for March 15th – April 30th.
Every year we move forward under the ACA, the fee goes up, and open enrollment windows get more narrow. If you don’t have health insurance yet, consider getting a short-term plan to cover you until the next enrollment date. You won’t avoid the fee, but you won’t go without coverage either.
I’ve just become aware of the fact that short term insurance does not exempt an individual from the penalty fee incurred on tax filing after assisting my 24year old with her search for a healthcare plan this weekend. The only excuse I can find for our unawareness other than not reading the fine print is why would one even think a penalty involved for taking responsibility for your healthcare.
It seems incredulous that an individual for numerous obvious personal life reasons pays for short term insurance which relegates one to covering all personal out of pocket costs for healthcare thereby acting responsibly for their healthcare debts. My husband and I are both self employed and have had a plan for many years with our health insurance co. Adding her to our plan later for 2014 was a non option given the extreme increase in policy fees for reason of a very weak pre existing rationale.
She went from a college plan / Anthem to a short term student plan in 2012 as she was deemed non- qualified by our insurance due to pre existing. She could not afford plans thru private insurers & hence the short term for catastrophic coverage. As an individual she pays 79.00 dollars a month insurance , biannual dr visit / sick visit fees, Annual Gyn 325.00 , eye exam , dental costs & full prescription costs – the equivalent of 4000.00 dollars last year. In a entry level position with no benefits a quality private insurance plan makes for much difficulty financially. I think the penalty is very unjust.
I see day in & out at my job people with no insurance using the ER & hospital resources with no ability to pay or insurance. There will never be a mechanism to recoup these millions of dollars of losses for care provided. This current system reinforces a poor model for healthcare & penalizes provides those who are trying to pay their way.
The benefit of short term health insurance is that it provides a health coverage option outside of open enrollment.
Short term can be paired with an exemption, or paired with paying the fee. For many, it’s preferable to simply not having coverage. That being said, it doesn’t have the same requirements as major medical coverage under the ACA, and thus, it doesn’t protect you from the fee.
If you were confused about this in 2014: you may be able claim the hardship exemption used for having limited benefit coverage in 2014, or the exemption for being confused about the fee. See the exemptions list obamacarefacts.com/obamacare-exemptions-list/ and the 8965 exemptions form.
Yes, I agree with you. I missed the deadline, because mistakes will happen. and I had the judge and jury on the line telling my excuses were not exceptable that was after i had been passed back and forth from anthem to covered California because neither said it was not their responsibility to assist me. after two hours anthem arranged a conference call with coverd California, and they both decieded that I should be penalized. I told them the fact of the matter is we cant afford it. on paper it looks like we do but they don’t consider debt to ratio. In cases like ours something or someone is not going to get paid. My real complaint with this whole set up is even if we could afford the premium, our deductible is so high that we would be able to pay for the diagnoisis but wouldnt be able to pay for the cure. Now what is wrong with that picture?
I created an account on Healthcare.gov Feb. 15th and submitted it said I would receive an “confirm” email. No email arrived so I tried to call; I could not get through it sounded like I was being put on hold then would click off. You can not resubmit the entered data so after a few hours of trying to call, to no avail, I opened a new hotmail account. By the time I submitted the info, AGAIN, I received an email stating open enrollment was over. This is ridiculous in today’s technology, especially through a government MANDATORY program. I am very disgruntled that I am unable to get insurance due to the governments inability to procure working website and phone lines.
If you had trouble enrolling in a plan you qualify for an extension in most states. See the information above on what to do if you missed the deadline and special enrollment periods.
Create another email address for yourself and create another account.
its easy to create a gmail account, don’t forget your user name and password ..
Your marketplace user name will be the new email address
You create your own password for marketplace. like “Healthcare1” would work
I had a company call me and threaten that I will pay a fine of over $3000 on my $13,000 income because I had not signed up for insurance yet through the marketplace, and had missed the deadline. If you’re going to enact a law, and have private agencies call about things like levies and fines, at least have them tell the truth and not fear monger. This country used to be great, and has the ability to be once again, and the affordable care act is a shining example of how it can distance itself from the stigma on it. But this…I can’t believe the level that these agencies are stooping to and clearly are guided by those higher up the chain. Sickening to say the least.
If you get any sort of call like this, go ahead and find out what company it is. You can then post it to our site and share it with our readers.
Someone please explain to me exactly how Obamacare is better than the way insurance used to be? I have been purchasing insurance out of pocket for years now, and the only way that Obamacare has affected my coverage has been very negative: 1. my rates have skyrocketed more than 25% since its introduction 2. insurance plans have drastically cut their networks to regain previous pre-Obamacare profit levels, which results in NONE of my doctors being in my network anymore 3. I can no longer shop around for alternate plans throughout the year, like I used to before Obamacare came around. It’s extremely frustrating, and enough to make me vote Republican in the next election, which is saying a LOT for me!
ObamaCare improves the affordability of coverage for millions, however in some regions it works better than others. In regions where supply of healthcare providers is limited, less expensive plans can have very narrow networks. It’s hard to point the blame in any one direction (after all your insurer set up the network and healthcare providers join networks).
It improves the affordability for millions? Really? I and my wife have both been working for temporary agencies and we cannot afford the insurance they offer and now the government will not cover us because the enrollment period is over (which is weird because I just started a new job two months ago and thought I was eligible for enrollment because of that.) Meanwhile, the best plan my employer has would run us between $250-$300 a week and doesn’t really cover anything for a year. So please, explain to me how the insurance is really more affordable when: 1. Costs for premiums has increased and 2. We are still having to pay out of pocket anyway since the insurance won’t cover us. Seems like instead of just paying out of pocket, now we’re paying out of pocket plus insurance premiums (for insurance we don’t need and cannot use.)
Affordable for tens of millions who qualify for cost assistance or expanded Medicaid and couldn’t afford coverage before. Affordable due to cost sharing limits for those who get cost sharing reductions subsidies. Affordable for those with preexisting conditions (technically 1 in 2 Americans) who were overpaying based on their condition or priced out of insurance. Affordable for those who had junk plans and would have ended up with dollar limits on services they needed to treat catastrophic illness or injury. Affordable for the women who paid more than men. A little more expensive (or a good deal more in some cases) for those who were benefiting under the old system. Obviously it’s not a catch-all statement that applies to every American. As defined by law though 8% of MAGI is “affordable”, so with that definition it applies to most. The high deductibles aren’t very consumer friendly on the surface, but they keep premiums low, qualify plans for ever amazing HSAs, and incentivize consumers to shop around for care. Shopping around for care and the higher insured rate are two factors that curb down the growth of premiums and the base cost of healthcare costs over time.
The above being said about affordability, employer plans can be a bit awkward. We have seen some really expensive employer coverage, even after contributions that simply doesn’t line up with what is offered on the individual market. It’s a burn for those who would have gotten a cheaper plan, especially with cost assistance, from the point of a consumer at least. On federal spending and tax dollars subsidizing the 50% plus who get coverage through their employer directly certainly poses it’s own set of problems and probably hints at why it’s not on the table.
On your other point, open enrollment usually works well. It ensures people hold their policy for a full year (that benefits the consumer due to annual cost sharing limits). It also works well for those who lose their plan for any reason other than non-payment, they qualify for special enrollment. It’s a little awkward in the case where one simply wants to switch to a more affordable plan.
My short term coverage ends 03/31 and i called to see about getting a full policy or renewing my short term and was told it won’t count towards having coverage and that i missed the open enrollment and that i can’t get a policy but will now be penalized monthly for not having it.
Short Term coverage doesn’t count as minimum essential coverage. But if you were confused about this, you have lots of options.
1. Call your state’s Marketplace and let them know your confusion before April 30th. It should trigger a special enrollment period.
2. If you had limited benefit coverage in 2014, because you were confused about the law, you will most likely qualify for one of the many exemptions for 2014. Specifically there is an exemption for limited benefit coverage (although it specifically is about Medicaid coverage).
Extra open enrollment
Hello, We signed up with an insurance company in New Mexico through the exchange. It was the same company we had in 2014, but we switched plans. We have been paying our premiums from Jan. 1-March 1, but they won’t acknowledge that we’ve paid anything. We have proof through our credit card company that our premiums have been paid. We have spent countless hours trying to rectify this with them over the phone, and it is never taken care of. We are not confident that this company to take care of our insurance needs. Can we switch to another company since there is an extension or are we stuck with this incompetent company for the rest of the year? It is New Mexico Health Connections, by the way.
Generally you can’t switch insurers mid-year, you can however switch plans if you qualify for a special enrollment period. You won’t qualify for the “extra enrollment period” described on this page (which is a special enrollment period based on qualifying life events unique to 2015 tax season). However, your experince may qualify as a “hardship”. You should call the marketplace and see if this experince qualifies you for a special enrollment period to switch plans.
Learn more about Hardship Exemptions: https://obamacarefacts.com/obamacare-exemptions-list/
Learn more about Special Enrollment: https://obamacarefacts.com/special-enrollment-period/
My husband and I had the mdwise healthcare plan all of 2014. In May of 2014 they asked for documentation of our US citizenship which I mailed his and mine in the same envelope immediately. We were covered and had few incident the rest of the year. In 2015 we were automatically enrolled and were sent our plan booklet and new premium which was sent for January and February on time. On March 2 2015 I received two letters from Health Insurance Marketplace. !st letter stated all info had been verified, 2nd letter stated my info had been verified but husbands had not so they had terminated his coverage ! I have called multiple times, had representatives be rude and hung up on 3 times. Finally I demanded to talk to a supervisor who said she would put in for a review of the matter but nothing really could be done since his info could not be verified. From the letter sent in May 2014 you only have 30 days to reply with your documents or be terminated. I just hear about this months later that they claim not to have his info ! I sent his documents and my documents all in the same envelope so how could they not get his. I don’t understand. I resent his again on March 6 2015 hoping they will see their mistake. They will not give me a name of anyone higher up to that I can appeal this with. The real glitch is when I asked to speak to someone who does the verifying I was told that that building “The Health Insurance Marketplace ” HAS NO PHONES ! They only communicate with MDWISE Marketplace via computer only !!!! REALLY. I have the names of everyone I have spoke to except the ones who hung up on. I really need to speak to someone higher up that can settle this matter. How can I prove I sent his and how can they prove I didn’t. This is so frustrating. Its not as if we get subsidy either. We pay a large sum every month for coverage. Very dissatisfied.
That is certainly a frustrating experience. One of the cool things the PPACA did was strengthen consumer appeal rights of insurance company decisions. Like you say there is a time limit on taking action generally, but considering this situation it still seems like the right move. Good luck and feel free to post your experience in our stories sections: https://obamacarefacts.com/obamacare-stories/
You can learn more about your appeal rights here: https://obamacarefacts.com/appeal-health-insurance-denial/ or here: https://www.healthcare.gov/appeal-insurance-company-decision/
So at the point you should go to Healthcare.gov and print out an appeal…Anything that you receive and any thing the CSR say to you if you believe it to be wrong you will be able to appeal and if you appeal the appeal REP will give you a number where you can be contacted in a few days and will be able to answer your questions you have
I am still confused about this fee I keep reading about. This is the first time I’m ever looking into Obamacare and I am overwhelmed. Can someone please explain what his fee is if this is the first time I’m ever considering signing up? No wonder my father gave up looking into this,last year. What a disaster.
The fee is a per month fee for every full month without an exemption or coverage. The more you make, the bigger the fee. But it’s never more than the average price of the cheapest marketplace plan. Common exemptions from the fee include: getting covered during open enrollment (which ended Feb 15), having less than three months without coverage, and coverage costing more than 8% of household income per person. The easiest way to get covered is to go to HealthCare.Gov during open enrollment. Since we are outside of open enrollment you should take advantage of the special enrollment period mentioned in this article. Go to the Marketplace March 15 – April 30 and attest that you were confused about the deadline, and then enroll.
Hope that helps.
Last year I tried to sign up for this mess. When I typed “Obamacare” in Google, it never took me to a site
I found one site that seemed to be legit, but because I am single and make over $45K per year, it said I didn’t qualify
This whole Obamacare thing is confusing
At $45,000 a year you actually just barely qualify for cost assistance. If you don’t already have coverage then you should go to HealthCare.Gov and look into special enrollment options. The cut off is $46,680 for 2015 cost assistance. If you max out an HSA it will help ensure you don’t claim extra income that would result in you paying back tax credits. You can also simply get a Marketplace plan (a plan you get through Healthcare.Gov or your state’s Marketplace) and then claim tax credits at the end of the year.
Am very confused
Assuming you don’t have coverage, and will owe the fee, you qualify for special enrollment from March 15 – April 30th. Go to HealthCare.Gov and enroll during that time.
In order to qualify you need to tell them:
You aren’t currently enrolled in coverage through the Health Insurance Marketplace for 2015,
You paid the fee with your 2014 federal income tax return, for not having health coverage in 2014, and
You were confused or didn’t know about open enrollment dates for 2015 coverage, and need another opportunity to enroll in coverage for the remainder of 2015.
You have to understand that to us citizens, the thought of getting a fine for not having health insurance, when illegals can get taken care of in hospitals without insurance is a joke. On top of that our government can spend almost a trillion dollars a year on weapons, fighting and killing innocents with drones, but we can’t even get health insurance for free, or at least not getting fined
I think this obamacare is a big mistake. It does have some good points and bad points to it. First thing is I agree everyone should have health insurance. They should focus on hospital and drug companies for cost savings. Also if they want to base this plan on peoples income they should send it all the way up the line not stop at 100,000.00 per year. Example if you make 1,000,000.00 a year you should have to pay 100,000.00 a year for health insurance. This way everyone feels the exact same pain. Not just attack the middle class. Also I’m an insurance agent that sells these plans and make money off of them and I’m disgusted how it has been going. They tell you how many people enrolled in the plan but never tell you how many kept it and paid the premium. For example I helped over a hundred people enroll only 60 people kept plan so that was a forty percent loss. I had people not pay a 8 dollar per month premium. So the inflated numbers you read are all not accurate and if you believe them you are not to bright.
If you look at the CBO reports they do take into account those who drop their plans, and those who enroll during Special Enrollment. Consider that 8 million enrolled last year, but only 4.5 million renewed their plan for 2015. Many of those were people who didn’t keep their plan all year. When we say “11.7 million enrolled” we mean enrolled, this is cool and exciting, but one wouldn’t expect 100% to keep their plan.
What is more important is: How many people think they have coverage, only to realize down the road that they missed their first payment (or another payment). Sure some percentage don’t pay on purpose. But what about those who want to, but don’t for some reason. This is yet another issue where “billing” should perhaps be everyones focus.
Also, if you take into account other ACA taxes (3.8% investment, excise tax, medicare tax hike, employer mandates) those with higher incomes are paying more for both premiums and taxes. Having health insurance cost 10% of anyone’s income or even 10% of national healthcare spending shouldn’t be the goal, rather it should be a driving force in curbing the cost of healthcare and passing smart legislation. There are few people out there who aren’t feeling the impact of the rising costs of healthcare.
Regarding the upcoming March 15th thru April 30th Special Enrollment, do ALL THREE of these conditions have to be met in order to qualify? What if my plan at work watered down benefits last month, and just want to cancel it and enroll in ObamaCare. Will the Special Enrollment allow this?
“•You aren’t currently enrolled in coverage through the Health Insurance Marketplace for 2015,
•You paid the fee with your 2014 federal income tax return, for not having health coverage in 2014, and
•You were confused or didn’t know about open enrollment dates for 2015 coverage, and need another opportunity to enroll in coverage for the remainder of 2015.”
-AL in Chicago
Yes, technically all three have to be met. But look at it this way.
“•You aren’t currently enrolled in coverage through the Health Insurance Marketplace for 2015, (this can be proved, you either do or you don’t, wouldn’t need to enroll if you already have a plan!)
•You paid the fee with your 2014 federal income tax return, for not having health coverage in 2014, (You may technically owe a fee, but actually owe ZERO because of your income or other exemptions. This itself shouldn’t bar one from enrollment.)
•You were confused or didn’t know about open enrollment dates for 2015 coverage, and need another opportunity to enroll in coverage for the remainder of 2015. (This is something you simply need to attest to, it’s up to you whether or not you were confused and want an opportunity to enroll.)
Thus, we would suggest that as long as you don’t have coverage, you should at least attempt to enroll. The important parts above are “you don’t have coverage” and “you want coverage”. Just make sure to attest to the above three facts when signing up during the “extra enrollment period”. To be clear, we are an unofficial informational website, so our advice is simply our advice based on our knowledge of the ACA and Marketplaces. HealthCare.Gov stated you must meet all three, not just one, of the criteria.
My husband lost a job at the end of last year. He was fully coverd by the healthinsurance from the employee in 2014. He found a new job and started on 1/5/2015 and supposed to be kikcked in to new healthinsurance by the new job on 4/1/15. However, he got layoff angain on 2/17/15 and found another job this month ( March). Unfortunatelly his newest employee is a small company and not provide the health coverage. We are looking for some alternative, possibilities. Is this EXTRA ENROLLMENT 3/15-4/40 would be one? Does he have a eligibility?
The “extra enrollment period” is slang for a unique “special enrollment period”. We are using it to distinguish it from regular “open enrollment” and the many other “special enrollment periods” triggered by qualifying life events. Generally, losing access to employer based coverage at any point in the year triggers a “special enrollment period” to enroll in a Marketplace plan. So he can enroll 30 days before he loses his employer-sponsored coverage through traditional “special enrollment” and doesn’t need to take advantage of the “extra enrollment period” described on this page.
My question was : my husband got a new job 1/5 and should have got a new coverage on 4/1, but since got layoff on 2/17, he missed the regular enrollment for obamacare 2/15.He was not covered by the employer yet when he lost his job. So it does not fit what you said.He did not have any employer-sponsored coverage yet. He missed the chance to enroll to Obamacare just 2 days. so in this case he can apply to this coming Extra enrollment?
I paid the penalty for not having insurance on my 2014 return. I made an attempt to get coverage during the enrollment period this year. I only make $70 – $200 per week. That would make me eligible for a subsidy. I went on and picked a plan. At no point did it tell me I was not eligible. I am very confused. I ended up getting billed over $400 a month. I didn’t pay it, how could I? It’s more than I make. When I was finally able to get in touch with someone I was advised that because I did not do it last year that I could not get a subsidy this year. I never saw that written anywhere. Where does that leave me? How am I supposed to get insurance on what I make? How do I comply with this mandate? Will I have to give up everything I make in order to be in compliance because I didn’t jump on this the first time? I meet all three of your conditions for this special enrollment but I can’t afford coverage without a subsidy. What should I do?
Your cost assistance on the marketplace (HealthCare.Gov unless your state created it’s own) is based on projected household income for the year. If you make between 100% and 400% of the Federal Poverty Level you qualify for assistance on Marketplace plans. Usually people take that assistance up-front, but it can also be claimed in-part or in-whole on your tax returns based on actual income.
The right move when you got the $400 bill would have been to call the Marketplace immediately and clear up the issue. Not paying wasn’t the right move, as that is one of the only ways to legally lose coverage anymore. You have lots of appeal rights, but an insurer can drop you for non-payment. If an insurer sold you a non-marketplace plan unknowingly, then you have the right to switch to a Marketplace plan.
What you should do at this point is take advantage of the special enrollment period discussed on this page, as long as your income is between 100% and 400% FPL. You’ll projected your income, then get cost assistance based on the projected income. The only way you won’t qualify for a subsidy is if your income is higher or lower than the above range.
Please note, you aren’t eligible for cost assistance if you have access to affordable coverage through an employer or are eligible for Medicare.
I am 63 and on disability. My wife is 59. My wife and i have been separated for the last 5 years. We have recently reunited. My wife being unemployed could not receive a subsidy for health care. Can she reapply as a married couple without penalties?
Cost assistance is based on household income. So if you are filing together then both of your incomes count toward cost assistance eligibility. This is still true when you become eligible for Medicare before your wife.
My wife and I have had private health insurance for years. I attempted to create an account at HealthCare.gov when ObamaCare first started. I spent HOURS trying, but due to the bad web site was unable to. Since our income is too high for a subsidy we have continued with our non-ObamaCare private insurance plans. Recently my wife’s premium was raised to an exorbitant level. I tried shopping around for an alternative plan, but apparently the only private health care available now is thru ObamaCare and is only available for a few month a year. I am paying 100% out of my own pocket and am receiving NO subsidy but I am not allowed to change companies when I want to? Apparently everyone w/o employer provided health insurance now has to get their health insurance thru ObamaCare? When will the government do the same thing to auto and home insurance? How about telling us there is only a 3 month window per year when we can upgrade our cars? This is ABSURD !!!
We understand your frustration, never fun to hear about that sort of thing. However, we would like to point out a few things in regard to this comment. 1) In most states there are lots of plans offered by insurers outside the Marketplace only. 2) Yes, people must shop during open enrollment, unless they qualify for a special enrollment period. There are tons of life events that qualify you for a special enrollment period. https://obamacarefacts.com/special-enrollment-period/. 3) The whole open enrollment thing works the way it does because insurers didn’t want to have people waiting until they were sick to get health plans. That would be like buying car insurance upon having an accident. Insurance is a collective fund that helps mitigate individual risk, if people don’t pay into the fund it doesn’t work.
Obamacare has been a nightmare for me. I am unemployed living off my little savings and I don’t qualify for a subsidy or medicaid. I can’t afford $330.00 a month for a HMO with lousy benefits. That is all I was offered in my region, so I couldn’t get insured. I have had insurance since 18 years old and that ended once obamacare began. I can’t afford it now and the HMO is not the plan that fits my needs. And, the price is unreasonable. Now, I am uninsured and living in fear of getting sick or injured. Very unfair. This law needs some changes to fit the needs and budget of unemployed people. And, why the narrow enrollment period? It should be available at all times. Things happen in life that prevent people from signing up on short notice. I miss the simple days.
Really sorry to hear this. It must be frustrating. Medicaid was supposed to be expanded to “cover the gap” between those who qualify for Medicaid and those who qualify for Marketplace subsidies (if you qualified for Marketplace subsidies your coverage would cost between 2% – 9.5% of your income). Your state along with many others rejected Medicaid because providing struggling Americans with health insurance was deemed “too expensive” by them. In short the ACA solved your issue, but your state reps unsolved it. Remember 45-ish million people didn’t have health insurance before the ACA, as you know there is nothing simple about not having health insurance and not being able to afford it.
I just recently got medicaid this March and I really need some extra insurance. Any help that could be provided will be appreciated. I do receive SSI
I enrolled on time & have paid premiums for 1/15 & 2/15. Due to some financial hardships, I was not able to pay premium for 3/15. Now I owe for 2 months. I have limited income & don’t see me being able to catch up. I had selected a gold plan in my area. Is it possible to now change to the minimum essential plan available in my market?
Usually we recommend a Silver plan. This is because the out-of-pocket assistance and tax credits can be adjusted mid-year without switching plans. Silver is the only plan that can have out-of-pocket costs adjusted. Typically once you enroll in a plan you are enrolled for the year. However, you can call the marketplace and adjust your projected income in order to qualify for more tax credits (or less if your income goes up) on a gold plan or any other marketplace plan.
Outside of open enrollment the only way to change plans is to qualify for a special enrollment period.
I’ve lived outside the country for the past 4 years. I plan on entering the states in April. How can I enroll? I also don’t want to be penalized, considering I have not lived in the U.S. I haven’t found any information that speaks on this subject. Is there a phone number I can call to speak to someone about this? Thank you.
This page should help explain what you need to know. https://obamacarefacts.com/questions/exempt-citizen-moving-outside-usa/
The most important parts are to claim an exemption for a 12 month period up until you move back and then to contact HealthCare.Gov about special enrollment so you can enroll in a plan that starts when you move back.
I got laid off from work and my medical insurance expired and I understand that I can enroll for Obamacare from March 15th to April 30th 2015
hoping to see if I qualify for it
I have no medical insurance at this time just seeking to find a primary doctor
I had tried to get insurance through Obamacare during open enrollment but hit a stumbling block with income verification. I have not filed taxes for 2013 or 2014 yet. During those 2 years my company lost money and have since closed the business. I am currently working with a set income and have been since October 2014. We are currently covered through Coventry but can no longer afford it and am going to lose it April 1st. I tried to change carriers last month and was told no one could quote me because I was already covered. My family policy increased $300.00 month Jan. 1st. We are currently paying $950.00 per month
My nephew is a college student, does not have health insurance, and was not aware of the original deadline. I told him about the special enrollment period and looked up the requirements. But he tells me he did *not* pay a fee with his tax return — he has no income and was exempted from filing a tax return. Can he still qualify for the special enrollment period? The website will not allow it if you answer “no” to “Do you owe a fee because you or someone in your household didn’t have health coverage in 2014?”.
Good question. We take “you would have owed the fee” to mean that it doesn’t matter if one could claim an exemption or not. Even if you can claim an exemption you would have owed the fee, and then not owed it after claiming the exemption. The not owing it is step 2, the fact is that before one could be exempt they would have to owe the fee. One could not claim an exemption, even the income exemption, and owe the fee. Does that make sense? If it were one of us trying to enroll that is how we would interpret the question.
Hi , I payed the penalty for 2014 on my taxes. and I think i qualify for the extra enrollment period for 2015. What number do I call to get help setting up Obama care ? Thanks Danny :}
Contact info for HealthCare.Gov for Individuals & Families
Call to start or finish an application, compare plans, enroll or ask a question.
1-800-318-2596 / TTY: 1-855-889-4325
Available 24 hours a day, 7 days a week. Closed Memorial Day, July 4th, and Labor Day.
Many people will be unduly penalized for not having health care coverage. I am one of them. I went to the doctor last week only to be told that my insurance had been cancelled. I called care first and was told that a cancellation letter was sent to me and a refund check for $815. When asked why, I was told that my January payment was short $37.25. That amount was added to my February bill, but still my account was cancelled. According to the representative that I spoke with, my refund check was mailed on March 12. Today is the 31th and I still haven’t received the check. I called the state health connection office and was told that they have been having that problem with care first cancelling peoples insurance. The representative told me that she got a call form a woman saying that Care first cancelled her insurance for 8cents. I ran into a lady in my city who told me that care first cancelled her insurance because they think she works too much. I have been purchasing private health insurance for over 15 years. Now with the new Obama plan, I am out of insurance, I cannot purchase one until open enrollment and I will be penalized for not having a plan. How is that helping me? How can this be right? I did everything right. I applied before the deadline. I was approved. I got a new card. I made my payments. The only thing I did wrong was, by mistake, paid the January premium $37.25 short. My monthly premium is $257.75. The fact that they are refunding $815 is an indication that I paid my premium. I’m still in shock. how can Care first get away with doing this to people? Who is protecting the little man? I never had this problem when I was paying $400 per month. I could purchase coverage at anytime then. This system needs to be fixed.
Thanks for sharing. Canceling a plan for legitimate non-payment is one thing, but the situation you describe is not that. If anyone ever feels slighted by their insurer in anyway we suggest both appeal and calling the Marketplace. Other good ideas would be posting about it on public forums like our site, letting the better business bureau know, and generally being vocal about it. It’s important to remember that nothing in the ACA actually gives the insurers any specific rights for pulling one over on consumers, rather the ACA is full of consumer protections. It doesn’t mean that people are protected from every bad practice out of the gate, but with so many options consumers shouldn’t have to stand from consistent bad business practices from any on insurer.
I had the exact same thing occur, I called my health insurance company in PA, the person I spoke with was very nice and said that it should not have been cancelled but he couldn’t do a thing and told me to call the Marketplace directly. I called the Marketplace directly and a very nice man told me that should not have happened and that he would connect me with his supervisor who would fix this. He connected me with his supervisor, who was not a very nice woman, who said that they would review this and could take up to 30 days to do so. I asked her if she thought going without health insurance was something she thought she might like to do…She told me to contact Pennsylvania’s Health Insurance complaint number. So I called them, got a recording that the caller volume was too high and to leave a message and then the Complaint Line hung up on me. Three times. So I emailed my local CBS TV Consumer Reporter who contacted Blue Cross (my insurer) and suddenly, I had insurance again!
Well that is an awesome outcome, but sort of a bumpy journey. It shows that when dealing with insurance in general the rule of thumb is don’t give up and appeal in whatever why you can. Glad to hear you were treated with respect for the most part.
My husband and i lost coverage in mid of January due to employment. We were planning on signing up through a private plan but we’re absolutely unaware that the private plans started using the marketplace enrollment dates as this was not the case in 2014. Due to this confusion wever missed the deadline . Would this qualify us ? We also only had coverage for the last few months of 2014.
If you don’t have coverage, and you would owe the fee from 2014, then yes you should qualify for the special enrollment period. Best way to find out is to go to Healthcare.gov or your state marketplace and answer the screening questions correctly.
These past five years have been the worse as I am concerned with medical coverage since ever having employment and unemployed. COBRA coverage was always an option.
Was not allowed to create an account. Message – We may need to fix a bug. No wonder people are confused and don’t have ObamaCare…. Don’t create a fee for those who don’t have it until it is simple to sign up…
I do not understand. I missed the deadline because I’ve been unemployed since 2009. I did not enroll because I didn’t think I was eligible.
Depending upon what state you live in you may no qualify for Medicaid (all adults who don’t make enough for the Marketplace qualify in many states). The best bet for anyone who is confused is to go directly to HealthCare.Gov and fill out an application. You can also simply get on the phone with their 24/7 customers service team and get further direction. There are literally tens of millions of people out there who qualify for free or low cost coverage and simply don’t know it. The only thing projected to change between now 2025 (when about 31 million uninsured before the ACA are projected to be covered) is people knowing that they are eligible to get covered. Even then about over 50% of those still without coverage will qualify for Medicaid or the Marketplace and just simply not sign up, many because they won’t even know they can. Crazy right? Call the Marketplace and then tell a friend.
I’m confused where I should be looking for insurance. I left my job in order to take care of my ill mother. When I put in my income which is 0 it brings up plans that are hundreds of dollars a month. Is this correct? How am I suppose to afford that with no income?
In order to get Marketplace cost assistance you have to make between 100% – 400% of the Federal Poverty Level (explained here https://obamacarefacts.com/federal-poverty-level/). If your state expanded Medicaid (explained here https://obamacarefacts.com/obamacares-medicaid-expansion/) then you qualify for Medicaid with income below 100% of the federal poverty level. You may live in a state that didn’t expand Medicaid. You could look into filing status’s (being a caregiver creates some flexibility). You can claim a number of different types of income, including non-taxable social security, which may help you access cost assistance in non-expansion states. (learn more about how income is counted https://obamacarefacts.com/modified-adjusted-gross-income-magi/).
If Obamacare is mandatory, you should be able to enroll at ANY TIME! Once again, it’s the little people, that already have no money (FYI…that’s why we don’t have insurance in the first place!), that are the ones being punished for not having insurance AND for not getting enrolled during “open enrollment”.
I never really paid too close attention to the health care changes, as I always had health care through my employer for the past 25+ years. That all changed in January, now my life is turned upside down due to this health care changes!
I lost my job January 16th, 2015 I immediately sought health care coverage for myself, my husband and my daughter. I looked at short term plans to get us through, until I could find work again. I was denied due to a pre-exisisting condition for which I take blood thinners. So fine, my daughter and husband went on one policy. A month to month short term plan with Preferred One, and I went on another through Medica.
February 19th I filled out the second month application for coverage for my daughter and husband. On Feb 24th, my daughter had a doctor visit for female issues, and had a pap smear and vaginal ultrasound. Feb 25th I received notification my husband and daughter’s coverage for March was approved and a few days later I received the insurance cards in the mail. A few weeks later my daughter was experiencing issues and we found out she needed surgery. I had the hospital call our temp insurance to see if it was covered and it was. We proceeded with the surgery. (everything now fine with her).
However, on March 24th, I received a letter from Preferred One rescinding coverage effective for the Feb-Mar time frame. They stated that on “question 5e- I stated that my daughter was not seen for any other reasons other than preventative care with in the last 30 days”. This was a correct statement, as my daughter had not seen anyone in the previous 30 days. However, they are saying it is 30 days from when the coverage would be effective. Not to mention, I had thought that a pap smear was preventative care…is it NOT?
So, not only have I lost my job…..but now I have a $20,000 bill we can not afford to pay.
Then, to make matter’s worse (which I thought could not be possible). I went to find coverage elsewhere for my husband and daughter. Only to come to find out the “OPEN ENROLLMENT” period has expired. I then see there is “SPECIAL ENROLLMENT” available. Great I think! Well, maybe not. To qualify for special enrollment you could have 1) Lost your job or 2) Lost your current health care coverage. Perfect I thought, as both has happened to us. Well, think again. You have to have lost your job with in the past 60 days. It is now outside that period, so we are out of luck there. And, because the coverage I did have for them immediately following the loss of my job was short term coverage that does not qualify as loss of coverage! We are SOL!
I have made several phone calls and am IN COMPLETE SHOCK! That is 2015, in the United States, I can not purchase health care coverage ANYWHERE for my daughter and husband. THIS IS RIDICULOUS! I have worked my entire life, paid monthly premiums into health care coverage consistently for over 30 years, have been an honest and hardworking individual, and am now screwed.
And to top it off, the last person I spoke with told me our family didn’t qualify for any other assistance because my husband makes more that the allowed amount. She did offer the lovely advice if he were to get fired from his job, we could qualify for the “SPECIAL ENROLLMENT”!
Finally, I’m also learning I will now be fined for every month we go without coverage, even though I would willing to pay and purchase it if I could find it available!
Are you kidding me? So much for healthcare for everyone…..
Extremely Disappointed in the Health Care System
Wow, so sorry to hear this. Ok so first you should appeal the health insurance decision. That little loophole with the short term shouldn’t just be accepted without exhausting every appeal option. Short term doesn’t play by the same exact rules as major medical, but it doesn’t mean you are out of options. https://obamacarefacts.com/appeal-health-insurance-denial/
For special enrollment, yes what you say is all technically correct. That being said there are a lot of exemptions from the fee (including one for un-payable medical bills) and complex situations for special enrollment (aside from the basics like moving or getting married). There isn’t a specific qualifying life event we have in mind, but take another look at our special enrollment page as we have complied all known special enrollment information in one place. Same thing with exemptions. This may give you ideas. Also wouldn’t hurt to try to qualify for the one-off special enrollment period happening now. One stipulation was that you had to owe the fee from last year, but you haven’t expressly said you didn’t… so if you do make sure to attest to this before the April 30 deadline (assuming your state has still kept the special enrollment going, some states ended this extension already). You can also try applying for Medicaid (with no projected income and a $20,000 medical bill you may just get accepted… or if your state didn’t expand coverage may be granted an exemption or other enrollment options based on this). The law and rules really work in favor of people in all sorts of situations, but assisters don’t always know all the ins-and-outs due to the wide range of options and qualifying information one may not know to even tell an assister. Hope some of this helps. Hang in there!
My husband lost his job toward the end of the year. He just start working again in January. We just got the insurance information and it’s to high. Am wondering if we can still apply for the Obama Care.
That is a hard one. The answer is probably no, unless you guys meet a qualifying life event during the year. You could try to use your states Marketplace before the 30th of April 2015, but you won’t have access to cost assistance. Having access to technically affordable coverage typically means that is the coverage you should take. Try looking into medical savings accounts (to save on tax dollars) and perhaps taking the cheapest plan offered. That could help offset the costs.
I have seizures that affect my mental status, with remembering things as one and I really need help..
The good thing about HealthCare.Gov is that all of your information is one place and they have a 24/7 help line. If you write down basic account info, your plan, due dates for premiums, and open enrollment dates (when you need to re-enroll) there isn’t much more too it. You can also keep your doctor network and benefits sheet (which shows cost sharing on hand).
I ended getting insurance yesterday through a local company. They said my insurance coverage starts June 1st. Will I have a problem with meeting the April 30th deadline.
April 30 is the last chance to enroll, plans purchased between April 15 – April 30 won’t start until June 1. As long as you got “minimum essential coverage” (not short term coverage) you’ll be safe from the fee from June on (assuming you keep your plan). Not sure what will happen with exemptions for 2015 taxes filed in 2016. But last year there were exemptions for those who enrolled during extended enrollment. So the Treasury department may offer another break. The April 30 date is about enrolling, not avoiding the fee from January – June. Still don’t have an official word on that. (although everyone get’s two months without the fee each year as long as they have coverage).
I have insurance until may 7, 2015 and need insurance after that. Will I still owe a fee even after getting insurance?
If you have minimum essential coverage, and then use special enrollment or another enrollment opportunity (like starting a new job), ie you maintain minimum essential coverage, then you’ll only owe the fee if you go with 3 or more months without coverage or an exemption. If you owe the fee, it’s per month for each month without minimum essential coverage.
when does enrollment open back up?????
Help need health. lnsurance Dental And Vision Poor health all needed feel very ill need emergency
We are a grassroots informational website and don’t offer professional legal, medical, or tax advice. That being said, in an emergency one should always go to the emergency room regardless of insurance. In a non-emergency one should get covered during open enrollment. If it is outside of open enrollment look into Medicaid options in your state or special enrollment options. Short term health insurance options are also available to those who qualify.
So how much of our taxpayer dollars do you get to defend every complaint against Obama care posted here? If it is so great why is congress not required to use it?
How do you justify not allowing people to change their insurance at will, have you actuall called the exchange ? The people have zero knowledge about the law and are absolutely no help
We get ZERO taxpayer dollars as we are individuals not affiliated with the Government (or health insurers). We are actually American small business owners who decided to learn about the ACA in order to help people understand it better.
Due to the time spent understanding the law we more often than not have a suggestion. Often comments are complaints and questions from people missing a part of the ObamaCare puzzle that can help them.
So on that note, we didn’t make the rule about open enrollment and special enrollment being the only time of year to change plans… but here is the reasoning (and this you may find interesting).
Before the ACA some states (including Massachusetts) tried to eliminate pre-existing conditions. The people loved it, but insurers hated it. It seemed when you let people switch plans and enroll in plans at anytime they simply waited to get a plan (or a good plan) until they needed it. When they needed treatment they would switch to coverage, get care on the insurers dime, and then drop insurance again when they didn’t need it. Massachusetts actually solved the problem (along with many others) with a little “Gruber / Romney magic” you could think of as ObamaCare 1.0 (https://en.wikipedia.org/wiki/Massachusetts_health_care_reform#Background). The Massachusetts reform created “open enrollment periods” each year (like Medicare has) which are the only times people can enroll in coverage or switch plans. This ensures that when you choose a plan you pay into for the full calendar year and this helps to make reform affordable for people and private companies.
Lastly if you don’t find Marketplace navigators useful you can always enroll in a Marketplace plan direct through your insurer or a local broker next year. This way you get the cost assistance of the Marketplace with the health insurance assistance of a private business.
The ‘special enrollment’ requirements negates the free market. I used to be able to jump from plan to plan based on premium rates. if I didn’t like one plan, I’d move to another…no issues. Now, I am locked into my plan and cannot reduce my expenditures for Health Coverage until the next “open enrollment” which the does not take effect till Jan 2016. The system sucks and I cannot wait for this fiasco to disappear!!!!
That is because before the ACA the insurer could just refuse to let you switch plans if you were sick. Trust me the open enrollment thing is not without reasoning. The insurers want to be able to sell plans all year, but they also need a way to prevent people from obtaining a cheap-o plan and then switching to a platinum plan when they get sick.
Actually, fun fact, before the ACA a few states made it so insurers couldn’t deny preexisting conditions and insurers were losing money hand over fist because people would wait to get coverage or switch plans when we were sick.
So open enrollment actually protects businesses and profits first and foremost. A free market gets to refuse the sale of health insurance, thus we have struggled to have a truly free market in regard to healthcare in America.
We are a small company – about 88 folks – and my understanding is that I don’t sign up until 2016. Is that correct?
Unfortunately due the complex nature of the ACA I may have to shut down and thus 88 people, including my office staff may not be employed. This is totally dumb. So 95 people on the unemployment role vs 95 people working. Does that make sense? I realize that Obama wants the entire population of the US on the streets – oh well.
The mandate applies to offering coverage to full-time workers. It’s based off of FTE (full-time equivalent workers) so all full-timers + part-time hours with each 30 equaling 1 full-time worker. For the fee it’s only per month per worker who gets subsidies on the health insurance marketplace or the first 30 full-time workers are excluded and the fee is paid for remaining full-time employees. So let us say half the 88 are full-time, that is 44. 44 minus 30 is 14. 14 x $2,000 is $28,000 if you just flat out pay the fee. If you just wait for the IRS to fine you for the workers who got subsidies it’s $3,000 an employee who gets subsidies… but not more than $28,000.
$28,000 isn’t nothing… but for a business with 88 employees it’s not unreasonable when you consider that is that businesses contribution to ensuring everyone has affordable healthcare. You can also simply offer coverage to those full-timers as part of benefits and enjoy the tax breaks. All of this being said, certainly everyone include small businesses and the people who work for small businesses is feeling the burden of the healthcare system… but this is why we need reforms like the ACA and certainly need to continue to look at how health insurance works in the workplace.
I find Obamacare to be ridiculous. FIrst of all the government takes out hundreds out of my paycheck every 2 weeks because im a taxpayer hard working american now your trying to tell me if i dont get this so called “affordable” health care insurance the money that is pretty much owed to me i wont be getting yet its okay for woman that are on welfare that keep popping out kids and cant afford to get a babysitter so they cant work to sit back and collect a portion of my paycheck and now im getting penalyzed. I had health net for a few months and let me tell you it did not cover anything why would i continue to pay for something that doesnt work anywhere i would go to get assistance? makes no sense right? Work hard americans….people on welfare are counting on us. Thats all thanks for letting me vent
You are absolutely right! I have the same sentiments. I know the crappy low level plan wont do a damn thing for me and if I don’t spend my money on that now it’s going to get taken away from the hard earned tax return/pay from my work year? The most asinine system I can think of.
Why is deadlines anyways? A person should be able to get insurance any day they can.I had insurance thru cobra from my last place of employment, the comany handling the insurance told me from day one that I was covered until the end of march of 2016, yeah 2016, was going to have a cat scan done the first of this month per my dr.orders, found out that the medical part of the insurance was cancelled the end of march this year maybe end of February I am getting messed up, they kept my dental insurance active, they did not notify me at all, here I thought I was covered until 3/30/2016, i had to leave my place of employment because of medical reasons and the company paid for the insurance thru cobra, i didn’t get anything in writing telling me what was covered and for how long, I would just get a summary in the mail saying that month was paid and July of 2014 they stoped sending it I contacted them and they said not to worry I was covered until end of march in 2016 the statement was just a formality I really didn’t need it because the company I worked for had paid it in full .cobra shut me off except dental, now I am screwed, help, I don’t work, I am 63 not old enough for Medicare I am getting my social security money and I have to pay the IRS for 2014 on top of that, help please, I have always had insurance thru an employer I don’t know what I am doing
In a case like this you’ll want to call the Marketplace (HealthCare.Gov) immediately and see if you can qualify for special enrollment based on these circumstances. Chances are you can. You can also try to appeal the employers decision on COBRA.
I kept missing deadlines because I found out about them after they had passed. I had insurance last year until my client of 9 years passed away. I still worked for the company but my hours had dropped below the hours needed to keep the insurance. I did regain those hours, but I was a couple of days too late. I work for the state. In Home Support Services. I am a caregiver. What can I do to take care of this. I have an appointment with a enrollment counsler on November 3. I have already met with her on October 20. Ms.Enriquez says that I am going to get penalised for lack of knowledge on this medical insurance stuff. I rarely ever see or need a doctor.The shortest time between doctor visits was a little over a year, the longest time was approximately 5 years.Do I qualify help or exemption on this medical insurance thing ? I will appreciate any information that you can get for me on this ! Thank you for your time ! Sincerely, H.
They are right, deadlines are the responsibility of the individual. That being said there are lots of exemptions to look at and special enrollment opportunities. HealthCare.Gov can help with both. During open enrollment you can enroll in a new plan no matter what, this will help correct any issues moving forward. The fee increases each year, so the sooner you correct the issue the better.
I was unable to meet the deadline as I was unable to get a job until May of 2015. My question is does that have any exemption possibility? and if not why have a deadline if you are going to fine people, for months not having healthcare, regardless??
So let’s imagine you have no money and no insurance (your state didn’t expand Medicaid). Then 6 months through the year you get a job resulting in you making $30,000 for the year. You essentially…. Oh wow, i’m not sure you do qualify for an exemption. Never thought of this before but it’s insanely unfair. Another big BS result of state’s not expanding Medicaid.
We would have to look closer to see if affordability exemptions can be taken for each month. This may be an option. https://obamacarefacts.com/form-8965-health-coverage-exemptions/
I relocated from Ghana to the USA on April 26, 2015. I got hired and started work in August 2015. My entire AGI for 2015 was 5915. My employer would not provide health insurance because i had not met the a specific tenure. Enrollment was not open for me to purchase insurance from the market place even whilst unemployed.
Would I be charged the penalty or can i claim an exemption?
You didn’t make enough taxable income to have to owe the fee. You can see all the exemptions on form 8965. https://obamacarefacts.com/form-8965-health-coverage-exemptions/
My wife and I are retired and living in Mexico because the cost of living is so much lower there. We retired on March 2012 and moved to Mexico. We both have dual-citizenship and maintain a permanent residence with our son in Colorado. Our CPA for over 25 years told us when we moved that we did not have to prepare annual tax report because of our SS only income. I am a military veteran and have the VA available to me for medical issues, my wife does not. Please advise me how we stand on Obamacare for my wife.
Got it. So you only owe the fee if you have to pay taxes in the US. If you don’t file a tax return, you don’t owe a fee. If you elect to file, then you need to file form 8965 and claim your exemption based on income.
I have sent “documentation” that ObamaCare demanded at least six times. The documentation I sent had proper identifiers, and was exact in every detail with cover letters and explanations. I have waited on hold for hours, and talked to representatives in person, as I was requested to do by your agency. I get letters monthly demanding the same items I have mailed in for months. Some of your requests overlap, demanding different sets of documents be sent. My citizenship and healthcare coverage is now at risk. I am Native American, so I am definitely a “citizen”. I recognize your system is very flawed. There is no continuity of communication and no two-way communication by mail, on-line, or by phone, because no one seems to have any authority to make decisions and problem-solve. Your “use” of technology takes away all hope of resolution. At first, I thought the documentation I sent would eventually “catch-up” with your requests, but that didn’t happen. How sad, and a waste of time and resources, that no one seems to care about the thousands of citizens with this same problem.