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When can I buy health insurance?

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A brief overview...
  • The open enrollment is the best time to buy health insurance
  • Consumers can buy insurance during State or federal extensions of open enrollment.
  • Consumers that qualify can buy insurance during a Special Enrollment Period
  • Applicants that qualify by age, disability, and work history can get Medicare coverage
  • Qualified applicants can get Medicaid and CHIP coverage at any time

The individual mandate of the Affordable Care Act requires health insurance for every eligible resident. The federal rules set a sign-up period from November through the following January for enrollment.Called the

Called the open enrollment, this is the designated time in which every qualified person has a right to buy health insurance. The open enrollment is the time to buy qualified health insurance that satisfies the requirements of the individual mandate.

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Open Season for Health Insurance

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The 2017 open enrollment will run from November 1, 2016, through January 31,2017. During the open enrollment period, consumers can renew an existing policy, select a new policy, cancel a policy, and switch policies.

Comparison shopping helps consumers find the best fit for their health care needs.

After Open Enrollment

The rule is that consumers cannot buy qualified health insurance after open enrollment period. Residents without insurance face the possibility of the individual shared responsibility fee for each month without insurance. The below-listed items describe the individual mandate penalty for 2016 and 2017.

The government calculates the fee on a per person basis and household basis. They apply the higher of the two at the rate of 1/12th for each month of no insurance.

2016 Individual Mandate Penalty

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The law imposes a penalty for no insurance called the individual shared responsibility payment. The below-listed items describe the details of the penalty.

  • The penalty is the greater of (1) household percentage or ( 2) per person fee
  • (1) household income- two and one-half percent of household income; or
    (2) per person fee- a per adult person fee of $695.00, plus a fee of $347.50 per child or minor person  up to a family total of $2085

The IRS applies the greater of the family household percentage or the total of individual penalties.

Purchasing Insurance Alternatives

After open enrollment, one can pay the penalty, seek an exemption, find an extension, or qualify for an exception. Buying insurance options include short-term insurance and Medicare.Public programs include Medicaid and the CHIP.

Public programs include Medicaid and the CHIP. Medicare has rules for open enrollment that include disability, age, work history, and date of birth.

Extensions

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The federal government can extend the time for open enrollment. It has done so to help applicants with incomplete applications, those delayed by long online waiting periods, and to help those delayed by system problems.Similarly,

Similarly, states have extended time for enrollment when fairness and events required them to do so. For example, when floods or storms interfered with the power grid.

Exceptions to Closed Enrollment

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The recognized exceptions to the rule against buying insurance after open enrollment are the special enrollment periods.Based on

Based on life events, these 60-day open enrollments permit subscribers to buy insurance after open enrollment closes. The recognized life events include the below-listed items.

  • Divorce.
  • Marriage.
  • Birth of a child.
  • Adoption of a child.
  • Moving to new location.
  • Loss of employer-sponsored coverage as an employee’s dependent.
  • Loss of coverage at age 26.

Short-term Insurance

The individual mandate requires qualified health insurance coverage. Those that fail to purchase during open enrollment can get insurance protection with a short-term policy.

This will not satisfy the individual mandate, but it will provide insurance protection. After the close of enrollment, the next opportunity to buy insurance may be the next open enrollment beginning in November of each year.

Short-term insurance can protect other interests that need insuring such as protection against expenses and unexpected events. These buyers can pursue hardship and other exemptions recognized by federal rules.

Advantages of Open Enrollment

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Buying insurance is best during the open enrollment. Subscribers can satisfy the individual mandate, avoid penalties, and take advantage of information and assistance from the federal or state marketplace.Comparison shopping makes the task easier. Comparison shopping can point to the most important features when searching for the best fit for the buyer’s needs.

Comparison shopping makes the task easier. Comparison shopping can point to the most important features when searching for the best fit for the buyer’s needs.

Comparison shopping makes the task easier. Comparison shopping can point to the most important features when searching for the best fit for the buyer’s needs.

High-Income Applicants

It is important that buyers with high incomes search both within and outside of the Obamacare marketplace. Incomes 400 percent or more of the federal poverty guideline get little or no subsidy on the exchanges.

It is important for these buyers to see the entire range of qualified policies and this includes qualified policies not offered on the exchanges.

It is important for these buyers to see the entire range of qualified policies and this includes qualified policies not offered on the exchanges.

Low-Income Applicants get Medicaid

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Medicaid does not require a purchase; it is open to those who qualify by income. Medicaid meets the requirements of the individual mandate; those covered by Medicaid will not face the individual responsibility penalty.

Those with incomes at or below the poverty level qualify for Medicaid in every state. Applicants can get Medicaid coverage at any time; it has a continuous open enrollment period.

Those with incomes at or below the poverty level qualify for Medicaid in every state. Applicants can get Medicaid coverage at any time; it has a continuous open enrollment period.

Medicaid Expansion

With the goal of including more families, Congress authorized Medicaid expansion in connection with the Affordable Care Act. Medicaid expansion provided funds for increasing participation.

The expansion raised the maximum income levels for Medicaid to qualify millions of additional applicants. Most states rejected the expansion and the funds and preferred to let their residents go without needed no cost medical care.

Children and Minors Get CHIP

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The CHIP is a public program of children’s health insurance. It does not require a purchase and eligibility is based on need. The program satisfies the individual mandate; it has the essential health benefits required by the ACA.

It does not have time-limited enrollment. Applicants can get coverage at any time.

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