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Health Insurance & Affordable Care Act

Window Is Closing To Sign Up Or Seek Changes To Obamacare Plans

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 “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.

People who don’t qualify for an exemption and don’t buy a plan might face a bigger financial hit than they anticipate. For 2014, the penalty is the greater of $95 or 1 percent of someone’s modified adjusted gross income over the filing limit ($10,150 for single person, $20,300 for a married couple filing jointly in 2014). 

 “We don’t talk about the $95 because it’s a complete myth,” says Brian Haile, senior vice president for tax policy at Jackson Hewitt Tax Service. Only a handful of people who might be subject to the penalty will have incomes low enough to qualify for that standard. 

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation.

Thu, Mar 06 2014

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