ACA Tip Sheet - What can families do now that enrollment is over but circumstances changed?

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What can Families do now that Enrollment is over but Their Circumstances Have Changed?

Apr 07, 2014

The enrollment deadline in the Marketplace is not being extended past 3/31/14, although, in the Federal Marketplace, people will be able to complete the enrollment process after the deadline if they had tried to enroll beforehand but were unable to do so due to technical difficulties.  See this guidance and this guidance from the Department of Health and Human Services, and/or this Health Affairs blog post and links therein. 

The good news regarding the next enrollment period, according to Kaiser Health News, “For next year, the enrollment period will be November 15, 2014, until February 15, 2015, one month longer than previously scheduled.” 

 

Man working at laptopWhat kinds of changes need to be reported?

Now that enrollment is over until November 15, families need to know that they still need to report life changes in the Marketplace.  (See below for information on Medicaid eligibility year-round.)  Such life changes that need to be reported include changes in:

  • Income
  • Marital status
  • Household size or who is dependent
  • Availability of “minimal essential coverage” or getting Medicaid
  • Disability status
  • Other life circumstances the may affect coverage

 

How do families report changes in circumstances?

Option 1: Families can login to their Marketplace account (or create one), go to their application, and then click on “Report a life change” button on the left menu.

Option 2: Even though enrollment is closed, families can still call the Marketplace at (800) 318-2596.

 

Good news on getting coverage after enrollment closes

If someone has an insurance plan that will expire after open enrollment, or they lose their employer insurance, they can still enroll in the Marketplace using a “special enrollment period.”  According to the Georgetown University’s Center on Health Insurance Reforms, “When your individual plan comes up for renewal you have a limited window starting 30 days before your policy year ends to sign up for a marketplace plan.”  See this resource guide, page 18. The summary of federal regulations regarding this is found here.    

     

Medicaid and CHIP enrollment is year-round

Families also need to know that they can sign up for Medicaid and CHIP year-round.  State Medicaid/CHIP (Children’s Health Insurance Program) information can be found here.

If for whatever reason families aren’t eligible for either a qualified health plan in the Marketplace or Medicaid, they may still get routine care at Federally Qualified Health Centers or either emergency Medicaid or charity care at hospitals for more serious conditions. 

 

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