How to Obtain Health Insurance

The Affordable Care Act (ACA) requires everyone to have health insurance or pay a fine, which can be as much as 2.5% of your household income or $695 per adult and $347.50 per child (up to $2,085), whichever is higher.

If you do not meet the requirements, you will have to pay a penalty fee when you file your taxes in April 2015.

This penalty fee increases every year, which means that it’s more important than ever to make sure you enroll in health insurance before January 1st of each year.

There is no correct time

The time you should sign up for health insurance varies by individual.

How long you have until open enrollment ends depends on when you are eligible to enroll. For example, if you’re a full-time employee of an employer who provides health insurance, open enrollment may only be 60 days a year.

If that’s your situation, it is recommended that you sign up for a plan by June 1st (60 days before your employer’s deadline).

If instead, it is left up to you how long until your plan begins, then some individuals may choose to go with a low premium plan and pay out of pocket for any medical expenses incurred in their waiting period.

This way they will not incur debt and will just have to wait longer for benefits coverage.

Open Enrollment Period (OEP) – Yearly

The OEP for 2018 began on November 1, 2017 and runs through December 15, 2017.

Each year, you have a certain amount of time to sign up for health insurance through your state exchange—otherwise known as open enrollment.

During that time period, your coverage begins January 1st of the following year. For example, if you enroll in December 2016 then you’ll be covered by February 1st of 2017.

If you enroll in January 2018 then you won’t be covered until April 1st.

Special Enrollment Period (SEP) – Once per year

It is possible to obtain health insurance outside of open enrollment if you have certain life events that qualify you for a special enrollment period.

For example, if you lose your job, divorce or have a baby, you could apply for coverage through your state’s Marketplace.

If your life event qualifies for SEP coverage, you’ll be able to enroll during that time frame.

However, it is important to note that these situations are rare and only cover small groups of people.

The majority of Americans still enroll in health insurance during open enrollment each year.

General Enrollment Period (GEP) – Twice per year

The subsidy refers to a financial incentive provided by government in order to make health insurance affordable.

Anyone who makes less than 400% of federal poverty level is eligible for an Obamacare subsidy, which reduces your premium from 10% up to as much as 9.5%.

If you are at or below 133% of FPL (federal poverty level), you can also qualify for a cost-sharing reduction, or a discount on your out-of-pocket expenses for health care services like copayments and deductibles.

To find out if you qualify for an Obamacare subsidy, plug your income into The Federal Poverty Level Calculator (FPL) .

You will be provided with current year figures based on your income tax return from last year and any changes since then.

What if I lose my job?

If you have a limited time between losing your job and your new health insurance kicking in, your best bet is a short-term medical plan.

These policies aren’t comprehensive, but they can provide basic coverage while you look for more permanent solutions.

Check with an insurance agent to find out more. (Note: If you qualify for Medicaid or other state-funded plans, then there’s no need to spend any money on temporary healthcare options).

When should I enroll?

When should you enroll in health insurance? The short answer is that it depends.

In some cases, health insurance enrollment windows are open all year long, giving you as much time as you need to compare plans and shop around for the right coverage.

In other cases, your enrollment window is shorter, so if you want to sign up for an employer-sponsored plan or a plan through Healthcare.gov, it’s best not to wait until just before open enrollment closes.

Here’s how different situations play out and what they mean for your coverage options

What to consider on open enrollment day?

Open enrollment is a chance for you to change or select your health plan and see if you qualify for premium tax credits and other savings.

If you don’t take advantage of open enrollment, you’ll remain in your current health plan until next year — unless, of course, something happens that allows you to make a change.

Those qualifying events include getting married or divorced, having a baby or adopting a child (including being named as a legal guardian), losing access to coverage through an employer because your hours are reduced or your job ends, moving to another state where you can’t be covered under someone else’s plan and becoming eligible for Medicare.

Open enrollment runs from Nov. 1-Dec. 15 each year.

How to get health insurance without a job

Unemployment is a challenging enough situation, but if you’re also trying to pay for your health insurance without a job it can be almost impossible.

If you aren’t eligible for COBRA coverage or Medicaid, there are still options available that might help you obtain health insurance.

Keep reading below and learn more about how to get health insurance without a job and how you can save some money while doing so.

Individual health insurance

You can buy a health insurance policy directly from an insurance company or through a broker.

Since you’re reading articles on HealthGrove, we’ll assume you fall into one of those two camps.

When purchasing individual health insurance, you have several options: You can get health insurance through an employer-sponsored group plan, or employee benefits program; If you’re already covered by another plan (for example, Medicare), and don’t want to drop it in favor of a new one; If your employer doesn’t offer health coverage; You’re self-employed and don’t have access to employee benefits programs; or You’re paying for health care on your own because your spouse has other coverage options at work.

How to get health insurance after open enrollment

When you have an employer-sponsored health insurance plan, you can rely on your employer to tell you when open enrollment starts and ends.

But what happens if you lose your job? Or what if you’re a freelancer and can’t get coverage through an employer? No worries—the Affordable Care Act (ACA) provides solutions for those who are looking for individual health insurance plans.

Under these new rules, people can buy health insurance either inside or outside of open enrollment.

Let’s take a look at some of the basics so that you can determine which option is best for your situation.

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