Obamacare: Here’s What You Need to Know About Open Enrollment

November 15 marks the beginning of the open enrollment period to get health insurance via the Affordable Care Act (aka Obamacare) Marketplace. The concept of open enrollment is familiar for those that have had coverage through their employer. However, for those that have always been on the individual market, or are part of the millions of Americans who obtained insurance for the first time in 2014, this may be a new experience.

Hereís what you need to know.

Open Enrollment is the only time of year that you can enroll, or reenroll, in a health insurance plan. Open Enrollment applies only to those who obtain insurance through an exchange, either through your state or the federal one. For the millions of Americans that obtained coverage this way, their coverage will expire as of December 31, 2014.

If there are no changes in your circumstances and your current plan is still offered, you can reenroll in your current plan. However, changes in income and plan availability may require different choices. Many exchanges have seen an increase in the number of plans available, so even if you werenít looking for a new plan, now is a good time to see if there are better options. Furthermore, changes in income could make you eligible for a different subsidy, which could help lower costs.

Most importantly, even if there are no changes, you still have to reenroll.

For 2015 coverage, the enrollment period is November 15, 2014 Ė February 15, 2015. It should be noted that if you donít update your coverage before your current plan expires on December 31, you will not have coverage under your plan and you may be subject to penalties for the months you donít have coverage. There is a three month grace period between the time of coverage ending and obtaining new coverage.

However, you will not be able to obtain coverage through an exchange after February 15, 2015.

Going through the exchange is most beneficial for those who would qualify for subsidies. It is possible to get insurance directly through a health insurance broker or an insurance company, though an exchange may make it easier to compare different companies. However, a broker or insurance company will not be able to offer subsidies to those who qualify.

There has also been an important change within the open market: Many health insurance companies have adopted an adherence to the ACA open enrollment schedule. This means that even if you decide to go directly through an insurance company, they may not allow enrollment in any plans after February 15, 2015.

It should be noted that this is not mandated by the ACA. Itís an unofficial policy the industry has undertaken as a way to prevent people who may wait until they are sick to obtain coverage. Itís a way they have chosen to get around not being able to deny coverage to those with preexisting conditions.

If you do not have a qualifying plan with minimum essential coverage in 2015, you may be subject to penalties. The annual penalty has increased for 2015 to greater of 2 percent of your income, or $325 per adult and $162.50 per child. If you are unable to find a qualifying plan that is less than the penalty amount, you will not be subject to the fee. The maximum fee for a family is $975 for the year.

The three month enrollment period is shorter than the six month enrollment for 2014 and will be the standard time frame going forward.

There is a chance that many people who werenít able to get coverage will be able to do so now. States with failed exchanges during the 2014 enrollment, such as Oregon, Nevada and Massachusetts, are now sending residents to the federal exchange to get coverage. Other states, such as Pennsylvania, have expanded Medicaid options, giving hundreds of thousands of low-income people access to coverage for the first time.

If you enroll in a plan between November 15 Ė December 15, coverage will remain uninterrupted and will continue as of January 1, 2015. If you are obtaining coverage for the first time after December 16, your coverage start date is dependent on enrollment date. Specifically:

Between the 1st and 15th days of the month, your coverage starts the first day of the next month.

Between the 16th and the last day of the month, your coverage starts the first day of the second following month. So if you enroll on January 16, your coverage starts on March 1.

If you qualify for Medicaid coverage or have a child that qualifies for the Childrenís Health Insurance Plan (CHIP), you can enroll anytime, even outside of the Open Enrollment dates. Furthermore, you will be enrolled immediately. Also, special circumstances that would affect coverage, such as a job loss or a birth of a child, would make you eligible for a special enrollment period should the event occur after February 15, 2015.

If you receive your insurance through your work, your employer will provide information on their open enrollment period, which may not coincide with the ACA enrollment. If you already have a plan, your insurance company may have mailed you information on the steps you need to take during this period. If not (or youíve misplaced it), Healthcare.gov provides some basic information on how to stay covered.

115 comments

Jim Ven
Jim Ven1 years ago

thanks for the article.

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Elizabeth Z.
Elizabeth Z2 years ago

The website is the most user-unfriendly ever! It is so confusing and unhelpful. The worst site I have ever visited! Good luck to anyone trying to enroll or renew their plan on coveredca! It is so ridiculous!

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Robert Hamm
Robert Hamm2 years ago

The ACA is NOT SOCIALIZED Medecine. BUT if you clowns dont work with us to make something REAONABLE happen then there WILL be single payer.

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Robert Hamm
Robert Hamm2 years ago

THIS plan dod NOTHING to haklth care at ALL. It isnt a hehalth care PLAN. It is a replacement or modification of an INSURANCE plan.

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Robert Hamm
Robert Hamm2 years ago

Corporations, more and more, are becoming global. in other parts of the world they have different healthcare systems. Corps dont want the employer based healthcare anymore because it makes it hard to compete with overseas comapnies. There are a LOT More dynamics going on here than the struggle between EVIL socialism and GOD given capitalism.
WE are no longer the BEST medical system in the world no matter how many times you cheerlead our country. Our system neeeds to evolve. I know you john birchers hate that word…..but its a fact. The world is changing by the minute. And your refusing to adapt to it is no longer a luxury the rest of the world is going to tolerate.

We need SOME kind of reform……. this system is falling apart and cant be supported anymore. POOR people cant be left to die so you won’t be inconvenienced.

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Robert Hamm
Robert Hamm2 years ago

David…………HEALTH care is not the problem. Health INSURANCE is. BIG Pharma is.
MAnY people create the ;lroblem and far too much of it i caused by GREED and cheating.
But oh HEAVENS no we cant have ANY regulations!!!! Regulations HAPPEN because enough people caused enough trouble transgressing against patients to create a squawk box of response. They lobbied the govenrment to fix it.
IF the system would simply regulate itself to make profit but not OBSCENE profit we wouldnt have a problem.
Of course some Docotrs get into the field to get rich jsut like some go into any field to do. The problem is David Insurers wanted to cover fewer and fewer people. They litigagted allll of their risk OUT of the equation. So what do we do with a alrger and larger segnmemnt of people who cant afford health insurance…….IF they can even get it? Do we let them die simply because they lost their jobs?? Do we let them die without care becasue have something an insurance comaopny thkinks is high risk??
The ACA didnt change the entire fabric of heatlh care. It tried to set up a way that the health insurers could tolerate. Well they decided they couldnt toerate even that. sO they started making excuses and people lost ALREADY horrible policies and blamed Obama for raising the rates when in Fact THEY did. The Republican Senators who wanted this to fail anyway refused to allow the state run plans that would allow the ACA to acrtually work correctl

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Linda McKellar
Past Member 2 years ago

MARY - BTW, I DID read your remark. I have NEVER heard of a bankruptcy in Canada due to medical bills. In the US @65% of bankruptcies are due to medical bills. Let's see him wiggle outa' that one! Hahaha.

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Linda McKellar
Past Member 2 years ago

David, sorry but I can't even read your crap any more. All I saw was "Fraser Institute" & that was enough....a right wing think tank (although connecting right wing with thinking boggles the mind). As Mary says same sh!t, different day.
I'M SURE THE APOLOGY FOR DENIGRATING MY 40 YEARS OF NURSING SERVICE (NO responsibility, NO incentive, etc.) WAS IN THERE SOMWEWHERE.
Thanks for that.

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Mary B.
Mary B2 years ago

David F.... your recent posts are the exact same crap you have posted for the last years as you try and justify your disgusting health care system in the US...... Don't regurgitate the same information when we have already proven you wrong......The US should be ashamed that health care isn't available to every man, woman and child and that a catastrophic illness or accident won't lead to bancruptcy.......

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Linda McKellar
Past Member 3 years ago

BTW DAVID, I certainly noticed you did NOT apologize for sullying my 40 year career as having NO responsibility, NO incentive, NO consequences, etc.
Well MARY, fellow nurse, notice how he addresses only what he can come up with bogus excuses for & even then contradicts himself? eg "Cost is no way to judge quality." Funny, he said it was SO efficient! Good grief on a bicycle!
Also perpetually ignores my own experiences as a patient.

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