Friday, March 14, 2014

What Do I do after March 31st if I still want a health insurance plan?

This Q & A comes from BCBS and is important to understand. If you don't sign up by March 31 2014 open enrollment deadline, you WON'T be able to purchase a health plan (except a short term medical which imposes a pre-existing condition clause), except by one of the below reasons.

See below.

Q What if a person’s situation changes and he needs health care coverage? Can he go to the Marketplace outside of the open enrollment period?

A  If a person loses his job or has another qualifying life event, he may qualify for a special enrollment period on the Marketplace. A person will qualify if:

  • He loses minimum essential coverage, including through divorce.
  • He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption or foster care.
  • He becomes a citizen, national or lawfully present individual.
  • He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer, employee or agent of the Marketplace.
  • The plan he enrolled in substantially violated a material provision of its contract with the individual.
  • He becomes newly eligible for premium tax credits or cost-sharing assistance.
  • He becomes ineligible for premium tax credits or cost-sharing assistance.
  • He makes a permanent move and has access to new health plans.
  • He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans one time each month).
  • He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him for special enrollment.
  • When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a health insurance plan or change plans.

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