En español l If you want health insurance under the Affordable Care Act (also known as Obamacare) but didn't get it when it first became available, does that mean you're blocked from buying it for another year? And if you bought insurance but your circumstances changed, are you locked into your current plan until the end of the year?
The answer to both questions: Not necessarily. If you meet certain criteria, you may be able to sign up — or even change plans — today.
"It's very important for people to know, so they can take advantage of these opportunities when they arise," says Rachel Klein, an expert on Obamacare at Families USA, a Washington-based health care consumer advocacy group.
Here's what you need to know.
The first open enrollment period to buy an Obamacare plan ended March 31. The next open enrollment — for coverage beginning in 2015 — will run from Nov. 15 to Feb. 15, 2015. But in a number of circumstances — including losing other insurance and, in some cases, not being able to get the website to work — you may be entitled to a special enrollment period (SEP) to sign up at other times of the year, according to officials at the U.S. Department of Health and Human Services.
Obamacare is not for you if you have health insurance coverage from your employer or a government health program such as Medicare or Medicaid. If you don't, though, the law allows you to buy private insurance through an online marketplace regardless of your health or preexisting medical conditions — and in many cases will provide government subsidies to lower the costs of premiums.
If you are entitled to a special enrollment period, you normally get 60 days to sign up after the event that triggered it. Beyond this period, you'd have to wait for open enrollment and you may get penalized for the time that you had no insurance.
Here are 10 circumstances in which you can qualify to sign up for a health plan within the insurance marketplace for the first time — or switch to another plan — without waiting for open enrollment.
1. You tried to enroll during open enrollment but couldn't
You were unsuccessful because of a malfunction on the website; an error made by a government employee; misinformation from an insurance company, agent or counselor; or system errors relating to your immigration status. Some examples:
- You followed the instructions for online enrollment, but a technical glitch didn't allow you to complete the process.
- You were wrongly informed — on the computer or by an agent or counselor — that you did not qualify for a premium reduction and therefore did not complete enrollment because you thought you couldn't afford it.
- You managed to sign up online, but the enrollment failed because it didn't reach the insurance company due to a technical glitch.
- You signed up online, but an error relating to your status as a legal immigrant caused the application to fail.
2. You lose health benefits from an employer
Benefits are no longer available due to the job ending — for any reason — or work hours being reduced. Or you've exhausted COBRA benefits that extend employer health insurance for a limited time. But you can't use a special enrollment period to sign up if you voluntarily drop employer or COBRA coverage, or if it's canceled because you didn't pay the premiums.