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Millions of Americans think they cannot get health insurance if they missed the extended open enrollment period that closed on April 30.  Actually, that’s not true.  There are a number of ways that still allow you to purchase health insurance after open enrollment in case you didn’t know that you were required to buy a health insurance policy for the year 2015, or simply ignored it and now face additional penalties.

Here’s how it works.

You can still buy health insurance through the Marketplace or off the exchange if you had one of the following qualifying events occur this year:

  • You lost your group health insurance because your employer cancelled the plan.
  • You left your job or were terminated from your job and lost your group health insurance.
  • You relocated from one area of the country to another.  For example, you purchased your health insurance in Kansas City and then relocated to Savannah, Georgia.
  • You had a child, adopted a child or had a child placed with you for foster care.
  • You got divorced and your spouse carried the health insurance, meaning you lost yours.
  • A spouse or family member died.
  • You had a significant change in income.
  • You gained U.S. citizenship or lawful presence in the U.S.
  • You were released from incarceration (no longer a jail bird).

Many have found that navigating the government website and/or trying to do this on line or with a call center can be a nightmare.

Unfortunately, those who manage to navigate the exchange on their own tend to buy the cheapest policy in the Marketplace.  This can have disastrous effects if you’re purchasing a bronze level policy with limited access and a very high out-of-pocket maximum (which can be as high as $18,000 if you use an out-of-network provider, hospital or ER).

Here’s the good news.  Using a knowledgeable, exchange-certified broker or agent like those at Benefits By Design costs you nothing and doesn’t increase the policy price.  It will, however, guarantee that you get through the process, and that you will understand the policy you are qualifying for.

Think of it this way.  Would you take a brand new BMW 750Li costing $85,000 to Jiffy Lube for repairs?  Probably not.  So, if you develop cancer and your medical bills for treatment are going to be in excess of $200,000, it might be a good idea to have access to the best doctors and hospitals in your area.  That’s what making an informed decision is all about.

If you paid the penalty when you filed your taxes, you may think that you automatically were enrolled for health insurance.  No, you weren’t.  It gets worse:  if you become sick and need medical treatment, you will pay for that treatment out of your pocket, in addition to paying the penalty.

Don’t have a qualifying event and still don’t have health insurance?  Here’s another option.  You can buy a short-term, month-to-month policy with one of the major carriers that will cover you in case of a catastrophic illness.  We jokingly call this the “if you get hit by a bus” policy.  It doesn’t have first dollar coverage for doctor’s visits and prescription drugs, but it’s real health insurance in case you have a catastrophic illness or accident.

So, yes indeed, you still can buy health insurance after open enrollment for all the reasons we just explained.  If you don’t, be prepared to pay the consequences.

Cary Hall

America’s Healthcare Advocate