Similarly, if people have enrolled in a marketplace plan and then discovered that it doesn’t include doctors, hospitals or other providers they need, they may switch to another plan at the same metal level offered by the same insurer, according to the federal rules. However, changes due to provider network issues must be made by Mar. 31.
By the end of February, roughly 4 million people had signed up for a marketplace plan on the federal or state-based exchanges.
Picking a plan is only part of the process of getting coverage. Benefits only take effect when you pay your premium, says Sarah Lueck, a senior policy analyst at the Center on Budget and Policy Priorities.
“If you’ve never paid your premium, your insurer doesn’t consider you’re covered,” she says.
People who haven’t enrolled by Mar. 31 may owe a penalty for not having health insurance in 2014.
In the past, people buying coverage directly from an insurer could generally sign up any time of the year as long as they got through the medical underwriting process that insurers used to evaluate applicants. Not anymore. Consumers who don’t sign up during the open enrollment period which ends Mar. 31 will generally have to wait until enrollment begins again next fall to sign up or change plans —unless their circumstances change, for instance, if they move, marry, or lose a job, among some of the more common examples.
In 2014, anyone who buys a plan during the open enrollment period won’t be penalized for not having insurance. However, people who bought coverage that begins April 1 or later (and who would otherwise be penalized because they had a coverage gap of three months or more) will have to claim a hardship exemption when they file their taxes next year to avoid the penalty.
There are a number of circumstances that may exempt people from penalties for not having insurance. The long list of exemptions covers things like affordability—if the cheapest plan available in someone’s area costs more than 8 percent of his or her income — incarceration, and hardships such as being evicted or filing for bankruptcy.
Thu, Mar 06 2014