Obamacare Enrollment Period - How to Apply for Obamacare

Open Enrollment Period

Overview

The open enrollment period for the 2019 plan year begins November 1, 2018 and ends December 15, 2018. Consumers looking for coverage to begin on January 1, 2018 must enroll by December 15, 2018. People experiencing life events that change their circumstances during the year, such as childbirth or job loss, should review our special enrollment period article.

  • Applications submitted between the 1st and 15th days of the month shall result in coverage beginning the first day of the following month
  • Applications submitted between the 16th and the last day of the month shall result in coverage beginning the first day of the second following month

Enrollment into an on-exchange qualified health plan can be performed through a health exchange marketplace, an insurance company that sells plans on an exchange, or an insurance broker that is qualified to sell plans on the exchange.

Obamacare Lock Out Period

After the end of the open enrollment period, most consumers lacking health insurance coverage will be locked out of the individual insurance market until the beginning of the next open enrollment period. These consumers will not be able to get effective coverage under a qualified health plan from the individual insurance market until January 1, 2019 at the earliest, but before that time they can still enroll in other kinds of off-exchange insurance such as short-term or large group plans. However short-term insurance plans do not qualify as creditable coverage, so short- term plan enrollees may still face a tax penalty for not being enrolled in a qualified health plan.

The tax penalty for individuals not enrolled in qualified health plans in 2016 is the greater of 2.5% of annual household income or $695 per adult1. In 2017, the flat fee will be adjusted based on inflation; the penalty based on annual household income will remain 2.5%. See our tax penalty article for more information. If an individual signs up late for a qualified health plan, then their penalty will be reduced by the proportion of time during which they were covered. Furthermore people that are uninsured for less than three months do not have to pay a penalty.2

During the lock out period, consumers in any marketplace can be granted a special enrollment period of sixty days if they have a qualifying life event.3 These events may include:4

  1. Exceptional circumstances (such as natural disasters, medical emergencies, and planned system outages) near the deadline
  2. Marriage
  3. Moving to a new location outside the provider network of their current plan
  4. Birth or adoption
  5. Losing existing health coverage
  6. Misinformation, misrepresentation, or inaction on the part of entities providing formal enrollment assistance
  7. Enrollment errors due to technical issues
  8. System errors related to immigration status
  9. Display errors on marketplace websites
  10. Delays in application transfers for consumers found ineligible for Medicaid or CHIP
  11. Error messages
  12. Unresolved casework
  13. Misinformation about availability of premium tax credits for victims of domestic abuse who are married but not filing a joint tax return
  14. Other system errors

Moreover there is no lock out period for Medicaid or CHIP, so eligible consumers can enroll in these programs at any time.5

Auto-Enrollment & Obamacare Subsidies

Consumers who enrolled in an Obamacare plan through the federal health insurance exchange are automatically enrolled in that same health plan for 2019 plan year. Any health insurance subsidies they received in 2018 could be applied to the 2019 plan year. Consumers interested in switching health plans, can do so during the Open Enrollment Period starting November 1, 2018 to December 15, 2018, though the dates may be subject to change.


Sources


1 https://www.healthcare.gov/fees/fee-for-not-being-covered
2 https://www.healthcare.gov/health-coverage-exemptions/exemptions-from-the-fee/
3 https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
4 Guidance for Issuers on Special Enrollment Periods for Complex Cases in the Federally-facilitated Marketplace after the Initial Open Enrollment Period. (March 26, 2014) http://www.cms.gov/CCIIO/Resources/Regulations-and- Guidance/Downloads/complex-cases-SEP-3-26-2014.pdf
5 Kev Coleman, Obamacare Open Enrollment Ends March 31st Despite Public Support for Extension. (March 7, 2014) /healthcare-research/surveys/obamacare-open-enrollment-period

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