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Obamacare open enrollment for 2016 ended Jan. 31, and open enrollment for 2017 won’t begin until Nov. 1, 2016, with new coverage beginning Jan. 1, 2017. What do you do if you need health insurance sooner? There may be situations in which you are not eligible for special enrollment or have to wait for the Obamacare coverage you buy during a special enrollment period to begin.
For those who are in between major medical plans and need coverage fast, temporary health insurance, commonly known as short term health or short term medical, can be a wise option.
It may be tempting go without health insurance. It is just a month or two, right? The Affordable Care Act allows individuals who are not otherwise exempt from the individual shared responsibility provision (i.e., mandate) to be uninsured for a single period up to three months each year. Beyond that, you could face a tax penalty (i.e., individual shared responsibility payment).
While it may seem unlikely you will need the benefits while briefly uninsured, going without health insurance can mean you will have to pay all of your medical expenses yourself.
A 2013 study found that $2,168 was the average cost of an emergency room visit for more than 8,000 patients nationwide. Of the top 10 reasons people visit the ER, kidney stones were most expensive and cost an average of $4,247 to treat and upper respiratory infections cost the least with an average of $1,101.
If you become injured or unexpectedly ill, are you prepared to pay for related medical care entirely out of pocket?
Life is unpredictable, even if you are in good health. Should situations you don’t expect to happen become reality, a short term health insurance plan can offer peace of mind that you have benefits to help pay for covered medical expenses until your ACA-compliant qualified health insurance plan takes effect.
Temporary health plans:
It is important to recognize that temporary health insurance plans are not ACA compliant and do not qualify as minimum essential coverage. They are intended for unforeseen circumstances and do not include essential health benefits or preventive care. If you go more than a single period of up to three months without qualified health insurance coverage and are not exempt, you may face a tax penalty. Short term health plans are not guaranteed issue and pre-existing exclusions apply, which means your health history can impact whether or not you qualify for coverage.
If you need a qualified health insurance plan to avoid a tax penalty or want access to comprehensive health insurance benefits, you may be eligible for a special enrollment period. Special enrollment periods are extended to those amid certain life events (i.e., moving, divorce, marriage, adopting or giving birth to children) and allow you to enroll in an ACA-compliant health insurance plan outside of open enrollment. During a special-enrollment period, qualified health insurance plans may be purchased through a state-based or federally facilitated health insurance exchange or in the private marketplace.
Open enrollment for 2017 health insurance plans begins Nov. 1, 2016, and runs through Jan. 31, 2017. To begin coverage Jan. 1, 2017, you must enroll in a qualified health insurance plan on or away from your state’s exchange by Dec. 15, 2016.
When you are in between health plans, contact your state-based or federally facilitated exchange or a health insurance producer, such as the licensed health insurance producers available by calling the number at the top of your screen, for assistance. These individuals can work with you to explore the best solutions for your situation.
This post was originally published on Nov. 3, 2014.
 Abrams, Lindsay. “How Much Does It Cost to Go to the ER?” The Atlantic. Feb. 28, 2014. http://www.theatlantic.com/health/archive/2013/02/how-much-does-it-cost-to-go-to-the-er/273599/