When Can I Purchase Health Coverage Under the Affordable Care Act?

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 Answer:  November 1, 2016—January 31, 2017 or  60 days after a Qualifying Life Event

 

Most people know they must have health coverage or pay a fine when they file their federal income tax.  However, did you know you can only sign up for qualifying individual coverage a few months every year?  Plans available outside of the Open Enrollment and Special Enrollment Periods lack the protections of the Affordable Care Act and do not meet the standards that prevent you from paying a fine with your income tax.  Keep the following enrollment periods in mind to make sure you don’t miss out on qualifying coverage.

 

Annual Open Enrollment

 

Everyone can buy individual health insurance during the annual Open Enrollment Period: November 1, 2016—January 31, 2017.  You can purchase health insurance through an agent, directly from the health insurer, or though the federal health insurance Marketplace (HealthCare.gov or 1-800-318-2596).  Keep in mind, if you want to utilize federal subsidies to purchase your coverage, you must buy directly through the federal Marketplace. 

 

Don’t wait until January to purchase or renew your health plan.  You must enroll by December 15, 2016 if you want your coverage to start on January 1, 2017.  If you purchase coverage between December 16 and January 15, it will begin on February 1, 2017.  If you wait until after January 15, your coverage will not begin until March 1, 2017.

 

Special Enrollment Periods

 

Special Enrollment Periods (“SEP”) are specific times outside of the annual Open Enrollment Period when you can sign up for health coverage on the individual market.  Typically you must experience a qualifying life event to trigger a SEP.  You should be prepared to provide proof that the event occurred when you enroll.

 

The most common qualifying life events include:

 

  • Involuntary loss of minimum essential coverage
  • Marriage or divorce
  • Birth or adoption
  • A permanent move

 

You have 60 days following a qualifying life event to enroll in a plan.  If you miss the SEP window, you must wait until the next annual Open Enrollment Period to apply for coverage.

 

I joined OPIC as a staff attorney in 2011.  I specialize in life, health, and disability insurance law.  I know that consumers can find themselves frustrated with these insurance issues at very difficult times in their lives—during sickness, after an injury, and after the loss of a loved one.  I am grateful that I can utilize my expertise to educate and empower insurance consumers as they navigate these challenges.