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Health Insurance Enrollment: Beating the Deadline

Health Insurance
Written by Michael Davies

THERE’S still time to get health insurance this year under the Affordable Care Act. But you’ll have to be quick.

The deadline for coverage in 2015 is midnight Sunday. Those who miss the cutoff won’t be able to enroll in a plan this year and will have to pay a penalty, unless they qualify for certain exemptions under the law.

In the first open enrollment period, from late 2013 to early 2014, government health insurance exchanges were flexible and extended the deadline for many people. That was largely because of technical problems that slowed down online applications. But the second time around, systems have run more smoothly.

People whose applications are pending when the midnight deadline hits should be able to complete them, Andrew Slavitt, a deputy administrator at the Centers for Medicare and Medicaid Services, said in a call Wednesday with reporters.

Still, it’s best to start the enrollment process as soon as possible to meet Sunday’s deadline.

Federal officials said that as the deadline approaches, traffic is increasing at Healthcare.gov, the federal marketplace, and at the exchange’s call centers. Despite the increase, however, they said the website and call centers were operating with minimal wait times.

From the start of open enrollment, on Dec. 15, through Feb. 6, federal officials said, 7.75 million people have either selected a plan or been automatically re-enrolled in one through Healthcare.gov; that figure does not include those using state-run exchanges.

An estimated 30 million adults in the United States remain uninsured, however, and almost half would qualify for premium tax credits under the law or for Medicaid, according to research from the Kaiser Family Foundation.

Help is available for those who are not sure how to proceed. “Some who are uninsured are unfamiliar with the process, and they really want to sit down with an expert and talk to someone,” said Anne Filipic, president of Enroll America, a nonprofit health insurance advocacy group. The group’s website offers a “Get Covered Connector” tool that lets consumers search by ZIP code to find local help; they can call to make an in-person appointment.

Assistance is available by phone and in person over the weekend. However, Ms. Filipic cautioned that time was short and consumers should be realistic: “There probably won’t be appointments available at 11 p.m. on Sunday night,” she noted.

Those who are unhappy with their coverage can also switch plans by Sunday. In most cases, existing plans have been automatically renewed for those who were covered last year, but did not actively re-enroll. If they qualified for a subsidy last year, it was included for this year. They can change insurance plans if they act by Sunday.

“You can still switch plans,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. Even if you don’t plan on switching, it’s a good idea to log on to the exchange and update your financial information by Feb. 15, to make sure your subsidy is based on your most recent income.

Here are some questions and answers about open enrollment:

If I sign up by Sunday, when will my coverage begin?

Your plan will become effective March 1.

What is the penalty for going uninsured in 2015?

The penalties for remaining without coverage increase this year, to $325 per adult from $95 in 2014.

When will the next open enrollment period begin?

The window is likely to be shorter now that users are becoming more familiar with the process. It is expected to begin in October and may end in December, rather than extending into 2016.

About the author

Michael Davies

Reporting on all things fun and exciting! Michael Davies has won many awards including a Peabody and Pulitzer Prize, but says his proudest achievement in life is his 8-year-old girl named Heather.

3 Comments

  • A health insurance “formulary” is split into “tiers” that determine how much a patient will pay for a drug. The following ranges of copays are typical ranges that we see for prescriptions in a pharmacy, but vary based on the insurance company and your plan. You should view your health insurance plan to see which medication tiers your coverage includes and their associated co-pays. Tier 1 usually covers generic drugs with a lower copay per prescription. Tier 2 may cover “preferred” brands, which typically have a “medium cost” copay. Finally, these companies typically reserve Tier 3 for “non-preferred” brands with slightly higher copays.

  • Hi Michael,

    Thanks for sharing such a wonderful article!!

    You have covered the important aspects about health and questions regarding open enrollment. Having the right cover can make a difference between life and death. You can never take chances with your health to save money.

    There are following benefits that comes along with heath insurance:

    Protects you and your family from medical debt

    Helps you to protect & manage your health

    Saves you a substantial amount of money on healthcare bills

    The health coverage allows you to access a network of hospitals, doctors and specialists for your medical needs. Hope I have made my point clear that health insurance is very important for all of us.

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