What were you doing this time last year? You may have been shopping for an Affordable Care Act health insurance plan on healthcare.gov. In 2017, you had until January 31 to select your plan.
Unfortunately, this year, you may be too late. For most people, the enrollment period for 2018 coverage ended on December 15, 2017. If you were relying on last year’s deadlines and waiting until the last minute—womp, womp—you probably missed the boat. That said, today may be your last shot if you meet certain requirements, says Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation (KFF).
Here are the exceptions that could give you more time to enroll in coverage:
You live in one of these three statesFirst, certain state-based marketplaces have opted to set their own enrollment periods, which offers you an extension of sorts. While some already ended mid-month, residents of California, District of Columbia, and New York can still apply through the end of today, January 31. (Check out this handy graphic from KFF.)
You may have also heard that disaster-impacted states received a hurricane extension, like Alabama, South Carolina, and Texas. For most, however, that expired on December 31. (For exceptions to this, see the link above.) KFF also suggests that if you live in Maine and couldn’t meet the deadline because of the extreme winds, you may get more time. For help, call healthcare.gov at 1.800.318.2596.
Your plan was discontinued
Did you received a notice that your 2017 non-group health plan was being discontinued this year? You have a “coverage loss” special enrollment period, which allows you 60 additional days to sign up for a new plan after yours ended, says KFF. That may mean you have until March 1 to make your pick (though you may go through a period where you’re uninsured if you wait that long).
You’ve had recent “life events”
Have a ring on your finger or a new baby on your hip? “There are qualifying life events throughout the year that would enable someone to sign up,” Tolbert says. “If you had a change in your family situation or other circumstances, call the marketplace and see if you qualify,” she says.
First, qualifying life event: marriage. If you recently tied the knot, you have 60 days from the date of your marriage to sign up for a plan (one of you has had to have coverage for at least one day in the 60 days prior) or choose a new plan for yourself. If you just had a baby (or adopted), you and your dependents likewise have 60 days from birth (or adoption) to enroll. Again, this applies all year long so if you expand your family at any point in 2018 you are eligible to sign up.
Similarly, you might be able to sign up if you made a permanent move or if you left your job (and thus lost the insurance you had through your employer). Again, remember the 60-day rule: that’s how long you have to sign up for something new. If you’ve left your job, know that signing up for COBRA will make you ineligible for the special enrollment period, and you’ll have to wait until next year to sign up in the marketplace. (Check out all the exceptions here.)
For people who make lower incomes (making around $16,000 for an individual), you may qualify for Medicaid, which you can sign up for all year long. Tolbert also notes that in Minnesota and New York there’s an additional basic health program. (Called MinnesotaCare and Essential Plan in New York.) People who earn up to 200 percent of the federal policy level are eligible, and like Medicaid, you can enroll at any point throughout the year, she adds.
None of those apply to me. What now?
You may have heard about short-term health coverage in order to bridge the gap during a time when you’re uninsured. However, know that these are not ACA-compliant policies, meaning they don’t automatically provide coverage in areas like maternity care, don’t cover preexisting conditions, and may not cover preventative services, either. (So-called “catastrophic coverage” is out, too, as it’s only available through the marketplace during the open enrollment window.)
“I would caution anyone considering a short-term insurance policy because they are not designed to be comprehensive insurance coverage. Depending on your situation, there could be potential benefits, but it’s more likely someone will end up paying a premium for a policy, and then the services they need won’t be covered,” Tolbert says. What’s more, they don’t qualify as minimum essential coverage, so you still need to pay the penalty (see below) for not having insurance, she notes.
OK, how much is the penalty?
If you don’t have the minimum amount of coverage, you’ll pay a penalty, between $695 for an adult ($347.50 per child) and up to $2,085 per family or 2.5 percent of the family income above the federal tax filing threshold, whichever is largest. That said, the fee is capped to the cost of the average bronze plan. In 2017 that was $3,264 for a single person and $16,320 for a family of five-plus, KFF notes.
If you do have to pay the penalty, your best defense next year is going to be a strong offense. All this to say: “mark your calendars,” Tolbert says. In most states, open enrollment for 2019 plans will run from November 1 through December 15, 2018. “These are dates people need to lock into their minds. During that timeframe, they should go to the marketplace and explore their options and apply,” she says, adding that even if coverage didn’t look affordable this year, things change, so it’s important to check it out every year.
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