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Friday, May 15, 2015

Ask a Navigator (May 2015)



Dear Navigator: I am about to change jobs and I will lose my health insurance. Can I sign up for new health insurance on healthcare.gov this year?

Hola, the open enrollment period for the Affordable Care Act (ACA) is over as of February 15, 2015, ay que triste!
The opportunity to enroll has come and gone with the wind, the doors are closed the ventanas are clo… well there is still some “special” enrollment windows that can be opened with certain life changing events. For example, you get a 60-day window to enroll in insurance if you are tying the knot with your amorcito, if you are having or adopting a new niñito or niñita, if you moved to a new residence, obtained lawful presence in the U.S., gaining citizenship also counts, leaving incarceration, you lost your health coverage, this can include losing Medicaid, getting divorce, losing job-based coverage including COBRA and or aging out of your parents coverage by turning 26.

Because you are changing jobs and losing your insurance, it appears that you will qualify for a 60-day window to sign up for new health insurance on healthcare.gov. 
See this infographic for more details about Special Enrollment periods. (pdf).

Being a member of an Indian tribe or an Alaskan Native gives you the opportunity to enroll at any point during the year. If you didn’t have insurance because you fell in the Medicaid Coverage Gap but now your income has increased above 100% of the federal poverty level (for more details, see chart here), you likely qualify for tax subsidies and you can enroll.

But remember, you have only 60 days from the moment of the life-changing even to enroll. If you miss the 60-day window, you miss out.

If you don’t qualify for any of these special enrollment periods, the next open enrollment period starts November 1, 2015 and ends January 31, 2016. You might ask yourself, why can’t I apply whenever I want? The purpose of enrollment periods is to stabilize and control the cost of health care by having sick and healthy people jump in the same pool at the same time. If you could enroll at any time of the year, the healthy people would wait until they became sick to purchase insurance, and having only sick people in the pool would raise the cost of coverage. Do car insurance companies allow you to buy insurance after you wreck your car? No way. During open enrollment, health insurance companies do allow you to sign up for any reason. But they close enrollment for about 2/3 of the year to protect themselves against adverse risk and to encourage people to sign up prior to becoming sick.  After all, the purpose of health insurance is to be covered at all times so that it’s there when you need it.  Keep in mind the only Utah health coverage that can be accessed at any time of the year is Medicaid and CHIP.

If you need help or have questions, find a nearby enrolment expert at the Take Care Utah website, or call 2-1-1. Take Care Utah helps people find and understand their new options for affordable healthcare coverage by connecting them with trained enrollment specialists in their communities. All services are provided free of charge.

Hasta luego,
Luis “El Navigator” Rios
Contact Luis via email or by call 801-433-2299 x.3 

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