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What Happens if You Miss Health Insurance Open Enrollment?

Posted By on Dec 6, 2016 | 0 comments


We’re currently right in the middle of the annual Open Enrollment period for health insurance, which opened on November 1 and will end January 31. You still have plenty of time to enroll in a health insurance plan, but what happens if you get busy and forget? There are two main consequences of procrastination, and neither of them are easy to get around.

First, if you don’t enroll in a health insurance plan as required by the Affordable Care Act, you will most likely be subject to a penalty on your income taxes. When you file your income tax return in the spring of 2018, you could be fined up to $2,085 if your family did not have health insurance coverage in 2017. There are exceptions to this rule, but they fall under pretty strict requirements and it’s difficult to qualify for them.

Second, going without health insurance can quite simply be dangerous. Even if you’re in excellent health, one accident or illness could set you back by tens or even hundreds of thousands of dollars. With quality health insurance plans so readily available – and most Californians qualifying for subsidies to help cover their premiums – neglecting to enroll in a plan simply doesn’t make sense.

But for various reasons, people still sometimes miss the Open Enrollment window. Luckily, regulations take into account changing needs during the course of the year. If one of these following conditions apply to you at any point, you can still enroll in a health insurance policy during a Special Enrollment Period:

  • You lose Medi-Cal coverage, employer-sponsored coverage, or COBRA
  • You turn 26 years old and must exit your parent’s plan
  • You turn 19 and are no longer eligible for a child-only plan
  • You move and gain access to at least one new Covered California health insurance plan
  • You have a baby, adopt a child, or receive a child into foster care
  • You get married, enter into a domestic partnership, or get divorced
  • You lose health insurance coverage after leaving military service
  • Your citizenship status changes
  • You are a member of a federally recognized American Indian tribe
  • You discover that you were subject to incorrect eligibility determination during the Open Enrollment period
  • There was an error processing your application during Open Enrollment
  • Your health plan violates its contract
  • … and many more life-changing events

If you think you might be eligible for a Special Enrollment period during the year, contact us so that we can discuss your situation. But if you’re reading this, then we want to remind you that Open Enrollment is happening right now, and everyone should investigate their health insurance options. Don’t put it off until later, when you’re likely to forget. Give us a call and let’s get started today.

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