The deadline is quickly approaching to enroll in healthcare coverage or change your coverage for 2019 under the Affordable Care Act (ACA), also known as Obamacare.
If you don’t sign up for a health insurance plan by December 15, you’ll likely be without coverage for months.
No need to worry, though. These steps can help ensure you select the best healthcare plan for you and your family.
How do I sign up?
There are a few ways you can apply for 2019 health coverage.
If you already have a 2018 plan, you can log in to update your application, compare plans, and renew or change plans for 2019.
For people living in most states, the easiest way to get started is by logging onto the ACA website, HealthCare.gov.
However, if your state appears on the list here, you won’t use HealthCare.gov. Instead, you’ll use your state’s website to enroll in individual/family or small business health coverage, or both.
Both HealthCare.gov and your state’s website will provide the information you need to enroll along with a number of resources and answers to commonly asked questions.
If you’re creating an online account for the first time, it’s helpful to collect the information you’ll need when you choose from the selection of online plans collectively referred to as the Health Insurance Marketplace.
You should gather relevant information, including:
- mailing addresses for everyone applying for coverage
- employer and income information for every member of your household
- everyone’s social security numbers
The Marketplace website will tell you which programs and savings you qualify for depending on your income and family situation.
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While the Marketplace ultimately decides whether you’re eligible for subsidies from the government to offset the cost of insurance, this page tells you how to make a ballpark estimateusing your income.
Using the government checklist found here will help you stay on track and ensure you have everything you need to enroll.
You can also apply for health coverage through:
- certified enrollment partner websites
- the help of a trained assister in your community
- a paper application
If you run into any issues during the application process, you can contact the Marketplace directly 24/7. The ACA website also provides a phone number to call if you need to speak with someone in a language other than English.
You can also ask for assistance from local organizations, agents, brokers, or assisters trained to answer your questions, either virtually or in person. Reach out as soon as possible because these organizations get slammed with requests in the days leading up to the deadline. Expect to have to wait for your turn, too.
Confused about all of the health insurance lingo? Check out the Marketplace glossary of common terminology.
What happens if I miss the deadline?
You must enroll in an insurance plan by December 15 to obtain coverage or you’ll have to wait until the next Open Enrollment Period to apply. Plans sold during the current Open Enrollment start January 1, 2019.
If you don’t act by December 15, you can’t get 2019 coverage unless you qualify for a Special Enrollment Period (SEP), which is a time outside the yearly Open Enrollment Period when you can sign up for health insurance.
You qualify for a SEP if you’ve had certain life events, including:
- losing health coverage
- getting married or divorced
- having a baby
- adopting a child
You usually have up to 60 days following the life event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply.
You can enroll in Medicaid and the Children’s Health Insurance Plan (CHIP) any time of year, whether you qualify for a SEP or not. However, you have to qualify for those programs, which target low-income families.
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Job-based plans must provide a special enrollment period of at least 30 days.
If you aren’t granted a SEP or if you want to contest another decision made by the Marketplace, such as the amount of your subsidy or whether you’re eligible for an exemption from the requirement to have health insurance, you may be able to file an appeal.
Will I pay a penalty if I don’t sign up?
If you didn’t sign up for health insurance in 2018, you can expect to pay a hefty penalty — also called Shared Responsibility Payment — of $695 for each adult and $347.50 for each child without insurance.
Although, the penalty per family is capped at $2,085 or 2.5 percent of your family income, whichever is higher. The fee will be applied when you file your federal tax return for 2018.
However, the tax penalty will be repealed and will no longer be in place starting January 1, 2019. This means if you don’t have major medical health insurance coverage for 2019, you won’t be penalized, even if you don’t have an exemption.