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What to Do Now If You Missed the Obamacare Deadline

The deadline for signing up for individual insurance under the Affordable Care Act has come and gone. The gates to Obamacare have swung shut, and if you didn’t get your paperwork done, you are locked out. So, what’s next?

If You Want Insurance

If you still want health insurance, you can probably get it. Private insurers are free to sell policies, the same as they did before Obamacare went into effect.

Some insurers are dropping out of that market, however. Under the Affordable Care Act, private insurers must comply with the law’s consumer protection provisions. For example, insurers can’t deny coverage to people with pre-existing conditions. That means insurers are going to pay out more in coverage, so if they stay in the individual-policy business, they’ll have to raise their rates or accept lower profits. Given those alternatives, many insurers are walking away from the business.

Still, if you want to buy an individual health insurance plan, you may qualify for a special open enrollment period if you have a qualifying life event that affects your health insurance needs. For example, qualifying life events include having a baby, getting married, getting a divorce, and moving to another state – among other things.

If You Qualify for Medicaid

Eligibility for Medicaid is based on income and it varies from state to state. In many states, more people qualify under expanded eligibility criteria. If you want insurance and you match Medicaid’s requirements, you can sign up anytime – there is no deadline.

If You Want to Take Advantage of Obamacare Exchanges

Tax credits and subsidies make it attractive to purchase insurance through the Affordable Care Act framework. Get your paperwork ready early so you don’t miss the deadline this time.

If You Have Exceptional Circumstances

You may be exempt from the Affordable Care Act’s requirement that you purchase health insurance or pay a fine. According to the federal government website, HealthCare.gov, there are eight exemptions:

  • You’re uninsured for less than three months of the year
  • The lowest-priced coverage available to you would cost more than 8 percent of your household income
  • You don’t have to file a tax return because your income is too low.
  • You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider.
  • You’re a member of a recognized health-care sharing ministry.
  • You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare.
  • You’re incarcerated, and not awaiting the disposition of charges against you.
  • You’re not lawfully present in the US.

If these conditions apply to you, you can simply ignore the Obamacare deadline. You don’t have to buy insurance and you will not be penalized.

If None of This Applies to You

If none of these options are applicable, then you will face a fine for failing to sign up by the deadline.

Note that the 2016 penalty will rise to $695 per person or 2.5 percent of income, whichever is higher. Penalties will be billed through the IRS as part of your tax return. If you are owed a refund, the penalty will be deducted. Otherwise, the IRS will bill you.

by: Dan Seitz
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