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How to get covered now that the Obamacare deadline has passed

While Monday marked the end of Obamacare’s first open enrollment period, it doesn’t mean that it’s the end of all Obamacare enrollment this year. There are a few ways you can still get covered, even though it’s past the deadline.  

Grace period: If you started an application before March 31, you have until April 15 to finish

If you began an application on healthcare.gov but didn’t finish because of technical issues (the website was down, you couldn’t get through to the call center, etc.) you have until April 15 to finish the online application. If you’re doing a paper application, you have until April 7 to get it in the mail.

You don’t have to prove that you had a technical problem- the site will ask you, but it’s on the honor system. Also, it looks like you can even start a new application until April 15 as well (we guess because some people may have had trouble creating an account in the last few days before the deadline).

By the way, the dates above are only for states where the federal government is running the online marketplace– states that are running their own sites may have a different grace period (if they have one at all). For example, if you live in Oregon, where the state website has been plagued by technical issues, you have until April 30 to enroll, no questions asked. To find out how the extension works in your state, healthinsurance.org (which is not a commercial site) has a helpful guide here.

There’s no deadline to apply for Medicaid

You can apply for Medicaid or the Children’s Health Insurance Program (CHIP) at any time during the year. Because some states chose not to participate in the Medicaid expansion, the income guidelines will vary from state to state. For states that expanded, anyone making less than the federal poverty line qualifies, and you can see the poverty line for your family size in the “100%” column here:

2014 federal poverty guidelines

And here’s a map showing whether your state is participating in the expansion:


Where the States Stand

Special Enrollment Periods

Remember that one of the promises of Obamacare was that if you lost coverage through your job or a spouse, you’d still be able to get insurance– and you can do that at any time through what are called “special enrollment periods.”

There are two reasons you might qualify for a special enrollment period:

1. If you have a “qualifying life event. Examples of qualifying life events include:

  • Marriage
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
  • Moving outside your insurer’s coverage area
  • Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. [Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.]
  • Gaining citizenship
  • Leaving incarceration
  • Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions

You then have 60 days after the event to apply for coverage through the online marketplace (or over the phone).

2. There was a complicated situation that prevented you from getting coverage before the March 31 deadline. This covers a wide range of stuff that might have happened when you tried to sign up for Obamacare– things like natural disasters, being hospitalized, misinformation from an insurance company or navigator, system errors, or domestic abuse. There’s a longer list of examples here on healthcare.gov. If you think you qualify for a special open enrollment period, contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) or your state’s marketplace and a representative will help you figure out if you qualify and, if you do, help enroll you in coverage.

You probably CANNOT get coverage outside of the exchange until the next open enrollment period

Earlier this week, the Associated Press did a story on options for getting coverage after the deadline, and it said that even though most people can’t get coverage through the Obamacare marketplaces until next November, you can still buy coverage straight from an insurance company– you just won’t get the subsidy to reduce your premiums. That’s not quite true.

Yesterday, the (and we’re not happy that we have to cite them, but they did do a useful thing) conservative think tank Heritage Foundation checked to see whether plans are actually still available off the exchange:

Our staff visited eHealthInsurance.com, where individual policies are usually available, testing one ZIP code for every state. For all but two states, we received this message: “Now that the Open Enrollment Period (OEP) has ended, you’ll need to experience a qualifying life event to enroll in a qualified health insurance plan.”

While insurance companies are allowed to sell Obamacare plans outside of the exchanges all year, the truth is that most of them will probably choose not to offer plans until November. Since they’re not allowed to turn people away for having pre-existing conditions, they’re worried that people will wait until they get sick to buy coverage (if everyone did that, insurance would be outrageously expensive).

If none of those situations applies to you

If it’s after the grace period in your state, and you don’t qualify for Medicaid or a special enrollment period, then unfortunately you won’t be able to sign up for coverage again until November 15.

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