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- The ACA requires every citizen and legal resident to have insurance coverage unless exempt
- The ACA individual mandate began as of January 1, 2014
- Coverage begins within sixty days of special enrollments
- Coverage begins within the extension periods of open enrollment
- The law requires twelve consecutive months coverage beginning on January 1
The individual mandate requires coverage on the first day of the calendar year and for the next twelve months. Every eligible person has a right to buy insurance during the open enrollment period.
For most people, the easiest time to buy insurance is during the open enrollment period. When selecting a policy, comparison shopping is an excellent tool for finding the best fit for an individual or family.
Comparison shopping goes beyond the price of monthly premiums. One can consider the impact of costs, coverage and the features one thinks are most important.
Compare private health care plans today so you’re ready when the next open enrollment period begins!
The Open Enrollment Period
The open enrollment period for the 2017 calendar year runs from November 1, 2016, through January 31, 2017. The open enrollment period is the best time to buy health insurance.
The ACA groups plans are organized by type and actuarial value. Comparison shopping permits consumers to pick the features they want and then make the comparisons.
Timing of Starts
The open enrollment period runs past the first day of January. It permits signups through the end of January. These January sign-ups will start in January or February on dates provided by the health exchange or federal marketplace.
In years after 2017, the federal government plans to end enrollment in December and start coverage for everyone on the first day of January.
Extensions to Open Enrollment
Extensions are short periods of extra days added to the state or federal open enrollment period. The states and the federal government have the authority to extend time.
Many extensions have come from delays or systems situations that affected consumers in the process of enrolling. These extensions have helped millions of citizens and residents sign-up. They have helped applicants complete incomplete applications, correct errors, and make final selections.
Using comparison shopping, consumers can compare features with particular importance to their individual or family situation.
Exceptions to Open Enrollment
The last day of the open enrollment period closes sign-ups for the rest of the yearly cycle. Special enrollment periods are exceptions to the rule against sign-ups after the open period closes.
Childbirth is a qualifying event, but pregnancy is not a qualifying event in the federal system. In New York state, pregnancy is a qualifying event for a special enrollment period. A state law established pregnancy as a qualifying event in the NY state exchange.
The state passed a law in 2016 that made pregnancy a qualifying event. In the federal system and other states, health insurance coverage begins with the birth of the child.
The Life Events
Federal and state rules recognize some changes as qualifying events for a special enrollment period. These are changes in status that require an opportunity to select new health insurance coverage. They include events such as moving to a new location not served by the existing insurance policy. The changes accepted as life events include the below-listed items.
- Birth of a child
- Adoption of a child
- Loss of coverage as dependent at age 26
- Loss of coverage due to job loss
- Loss of coverage as a dependent due to job loss
Medicare begins at different times for each. The factors that determine the start time include age, physical condition, illness, and work history. The seven-month application window runs from three months before a qualifying birth date, the birth month, and then to three months afterward. Applicants must also decide when to use Medicare, and they can delay using it to increase benefits.
Medicare Part C offers a large number of choices including premiums and prescription drug coverage.
Medicaid is Always Open
Medicaid is available on a year-round basis to qualified applicants. Applicants can get consideration at any time, and marketplace staff routinely refer those they do not accept for possible enrollment in Medicaid.
A state-run program, Medicaid coverage satisfies the requirements for qualified health coverage and essential health benefits. Medicaid has income limits and persons with too much income may not qualify even though they do not have enough income to qualify for an Obamacare policy at the federal or state marketplace.
There is a minimum income needed for an Obamacare plan and a maximum amount for eligibility in Medicaid. The federal government labeled the difference as the Medicaid gap.
The Congress enacted Medicaid expansion to erase the gap and allow persons with higher income levels to sign-up for Medicaid.
Many states did not accept the federal funds to expand Medicaid and left these vulnerable populations without needed medical care nor the means to get it.
The CHIP has Year-round Enrollment
The Children’s Health Insurance Program protects infants and minors. It is open continuously for qualified needy children. The coverage in the CHIP meets the standards of the Affordable Care Act and children covered by the CHIP will not have to pay the individual shared responsibility payment.
Employer plans do not have to follow the federal or state rules on open enrollment dates. When hired, large employers must offer insurance to new employees within ninety days.
The start date of insurance could be anywhere in the ninety-day period. Should the employer not offer affordable policies, the employee can request quotes from the local or federal marketplace.
Health Insurance Begins in January
January is the beginning of the health insurance year. Coverage begins in January for those signed up by December. For subscribers using extensions or exceptions, the insurance starts at a date determined in the application process. Comparison shopping makes the process of selecting a policy more productive.
Consumers can use experience, research, and expectations to focus on the features that matter most.
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