Open enrollment for 2015 coverage in the healthcare Marketplace has come and gone.  So what does that mean for you?  If you’re uninsured, you may have to go another year without coverage.  The next open enrollment period begins November 1.  You may also have to pay the Obamacare penalty when you file your taxes next year.


What are your options? 

Special enrollment period: Special enrollment periods are available only to those who experience a qualifying life event.  After reporting the event to the insurer, you will have a limited amount of time to pick a new policy.  Typically a special enrollment period allows 60 days for enrollment.  Some qualifying life events include:

  • Having a baby, adopting a child, or putting a child up for adoption
  • Getting married
  • Moving outside of your old plan's coverage area
  • Losing your previous health insurance plan
  • Gaining citizenship or legal resident status
  • Being newly released from incarceration
  • Gaining membership status in a federally recognized tribe or as an Alaska Native 
  • If already enrolled through the Marketplace, you may be able to qualify if changes to your household size or income affect your eligibility for Obamacare subsidies


Medicaid or CHIP: Enrollment in Medicaid and the Children’s Health Insurance Program is available year-round.  If you apply and are denied, you may qualify for a special enrollment period in the health insurance Marketplace. 


Qualify for an exemption: Some people are exempt from coverage requirements. They will not have to pay a penalty. Some Obamacare exemptions can be claimed on the tax return; others have to be applied for through the Marketplace. You may be exempt if:

  • Your income is low and you are not required to file a tax return.
  • You would have to pay 8% or more of your household income for health insurance.
  • You had only a short gap in insurance coverage, less than three months.
  • You lived abroad for at least 330 out of 365 days.
  • You experienced financial hardship in acquiring health insurance, such as trouble paying major living expenses.
  • You were denied Medicaid because you reside in a state that never expanded eligibility under Obamacare.


If you think you could qualify for one of the Obamacare exemptions, especially if you experienced a hardship, you should seek advice from a tax professional.  Our online Health Coverage Exemption Guide can help you determine if you qualify for a coverage exemption.  Call our ACA Hotline at 1-800-673-8600 for more information.


-- By Alice Robeson