How to Get Health Insurance if You Missed the Enrollment Deadline

If you made it through the holiday season and now realize that the deadline for open enrollment for health insurance has passed, you may still be able to sign up. The Federal government chopped a few weeks off last year’s enrollment deadline, so they are making some exceptions. The first thing you need to know is that while you may be able to get on a health insurance plan at this late date, that doesn’t mean you will be able to use the plan as one is deemed to be qualifying health coverage under the Affordable Care Act. In other words, it may cost you money at the end of the year.

Any plans that are available from private health insurers from the www.healthcare.gov website will meet the criteria for a qualifying plan. First, you must meet the Special Enrollment Period test requirements. Begin by going to www.healthcare.gov and clicking on the button that says “See if I can enroll.” You will have three options to choose from. If you qualify for Medicaid or CHIP federal programs, you should be able to get health coverage by filing at your local office. You select the third option to begin the process of filing for coverage once you pass the Special Enrollment Period test.

The next screen you will see is a warning that because you complete the questionnaire or the questionnaire results show you may be eligible to use the Special Enrollment Period, there is no guarantee you will be accepted. But passing the test means you are still in the running for health care coverage. Though the exact combination of “Yes” answers to the questions that you is unknown, the more “Yes” answers you select, the more likely it is you will qualify. There is no need to misrepresent any information since your answers will be checked once you begin the application process.

The questions are simple and straightforward. If you have been denied coverage from Medicaid or CHIP, have lost your coverage in the last 60 days, or are a member of an American Indian tribe recognized by the federal government, check the relevant “Yes” buttons. The second group of criteria involves anyone who is currently a member of your household. Be sure to answer the questions as “Yes” if it applies to anyone living with you.

Basically, if the number of people who live with you has increased or decreased, you will answer “Yes” to at least one question. If you moved or had a significant change in the amount of money you make, that is another “Yes” to be checked off. Finally, if you recently joined the society as an immigrant or been released from a correctional facility, that is another “Yes” box to be checked. If you are still in the running after clicking on the green button at the bottom of the screen, you will be asked to begin the application process. If you do not already have a healthcare.gov account you will be asked to create one. You will be notified of the progress of your application by the government.

But don’t give up just yet if you are denied! There is a list of what the government calls “complex issues” or “complicated cases” which is complicated in itself. The entire list and their descriptions can be found at http://www.healthcare.gov/sep-list/ but here are a few examples.

Misinformation, misrepresentation, misconduct, or inaction of someone working in an official capacity to help you enroll kept you from one of the following:

  • Enrolling in a plan
  • Enrolling in the right plan
  • Getting the premium tax credit you were eligible for
  • You experience domestic abuse/violence or spousal abandonment
  • If you meet any of the conditions in this second exception group, you will have to call the Marketplace Call Center at 1-800-318-2596.
  • If you are still denied, you can file for an appeal at the address at the bottom of the page.

The important thing to remember throughout this process is that you need to enroll in a qualifying plan. You may find the number of coverage policies and options limited, as not all insurance companies participate in making late Open Enrollment insurance coverage available. Though there is no time limit specified when these special enrollment options will end, you should not waste any time in acting and getting the process moving forward.




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