Understanding the Open Enrollment Period of the ACA

Posted on: Thursday, January 9, 2014

The Affordable Care Act is officially in effect, and the clock is now ticking down to the end of its first Open Enrollment period. If you do not have health insurance coverage, or wish to change your existing coverage, then you have until March 31st to sign up through the Health Insurance Marketplace. The next Open Enrollment period is scheduled for October 15th to December 7th. 

What Happens After March?

If you have what the ACA describes as a life event, you may be able to enroll for, or change, a plan. These special enrollment periods generally run for 60 days after the life event has occurred.

A significant event includes:

  • Moving to a new state
  • Change of marital status
  • Birth of a child
  • Loss of employment

If you would like to switch your healthcare coverage in 2014 to something more affordable, then you must do it before the end of March. Voluntarily leaving your health insurance plan will not, in itself, qualify you for a special enrollment period.

Medicaid and CHIP

Millions of families also depend on Medicaid and CHIP, or the Children’s Health Insurance Program, and there is no specific enrollment period for those programs. Eligibility for these plans can be determined by filling out an application on your state’s marketplace, or by contacting your state’s Medicaid office. 

It is also important to know that some states expanded their Medicaid coverage. When the Affordable Care Act was passed, states were required to provide Medicaid coverage for all adults between ages 18 and 65 with incomes up to 133% of the federal poverty level, regardless of their age, family status, or health. The federal government will pay states all of the costs for newly eligible people for the first three years. It will pay no less than 90% of the costs in the future. However, the U.S. Supreme court ruled that Medicaid expansion is voluntary among states, so not all chose to participate in the expansion plan. For many adults in these states, their incomes are too high to get Medicaid under their state’s current rules, but their incomes are too low to qualify for help buying coverage in the Marketplace. Under these circumstances, adults likely will meet the requirements necessary for an exemption to the ACA penalty clause. It benefits everyone who falls into the general Medicaid eligibility requirements, however, to apply for benefits, if only to see if they qualify. Many states have unique coverage options which may apply to many applicants. 

If all else fails...

The Affordable Care Act expanded funding to many qualified community health centers, which provide excellent primary care to millions of Americans. Should individuals somehow fall through the crack in every other way, these health centers will still be available.

Got questions about the new health care laws?

Core Benefits Group has answers. Please call us at 1-877-214-2969.

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