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3 Summer Health Insurance Options for the Uninsured

3 Summer Health Insurance Options for the Uninsured

Posted Jun 30, 2016 by Jenifer Dorsey

Summer is no time to be without health insurance. While it may not be the height of cold or flu season, summer tends to be an active time for many people and injuries and illnesses can happen no matter the season.

However, due to circumstances that may be beyond their control, some individuals and families find themselves without healthcare coverage during any time of year for many reasons. Those reasons may include losing a job, moving to a new area, and turning age 26 and aging off a parent’s health plan, to name a few.

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Fortunately, if you find yourself looking for health insurance during the summer months, you have a few options to get you by until 2017 open enrollment.

1. Short term medical insurance: temporary health insurance plans for those in-between times

If you are not eligible for a special enrollment period or have to wait a few weeks before your new Obamacare plan or employer-based coverage begins, short term health insurance can provide you with temporary benefits for a range of unexpected healthcare expenses

How much does short term coverage cost?

Premiums for short term policies tend to be lower than premiums for major medical policies (i.e., Obamacare plans), and the benefits can help you pay for unexpected healthcare while you are in between major medical policies.

Advantages: You can obtain a short term plan for as few as 30 days. Coverage can be obtained online or through a health insurance producer within minutes and begin quickly—as soon as the day after you apply. Premiums for short term policies tend to be lower than premiums for major medical policies (i.e., Obamacare plans), and the benefits can help you pay for unexpected healthcare while you are in between major medical policies.

What to know: Short term plans are not ACA-compliant. This means you could owe a tax penalty if you go more than a single three-month period without Obamacare plan and are not exempt from the individual shared responsibility provision. You may also be denied coverage based on your health history.

 

 

2. Obamacare – special enrollment periods for qualifying life events

Open enrollment for 2016 Obamacare plans ended Jan. 31, 2016, and open enrollment for 2017 plans won’t begin until Nov. 1, 2016, with coverage beginning Jan. 1, 2017, at the earliest.[1] If you become uninsured in the meantime, you may qualify for a special enrollment period—a limited time during which you may buy an Obamacare plan in the private market or through a state-based or federally facilitated health insurance exchange.

Qualifying life events such as getting married, moving, losing health coverage and having a child can make you eligible for a Obamacare special enrollment.

Advantages: You may save money on healthcare expenses and premiums, if you qualify for a premium tax credit or cost-sharing subsidy and purchase your Obamacare plan through a state-based or federally facilitated health insurance exchange.

Estimate Your Tax Credit

If you are subject to the individual shared responsibility provision (i.e., individual mandate), enrolling in an Obamacare plan can help you avoid the individual shared responsibility payment (i.e., tax penalty).

What to know: Often called Obamacare plans, major medical insurance plans are subject to the Affordable Care Act, regardless of where they are purchased. Among other requirements, they must include essential health benefits and certain preventive care services. They are also guaranteed issue, which means you may not be denied coverage or charged more based on your health history.

 

3. Medicaid: low-cost or no-cost coverage

If you find yourself uninsured at any point during the year, you may be eligible for Medicaid, a state-federal program that provides low- or no-cost health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities.[2] Medicaid open enrollment lasts year-round.

Advantages: Medicaid fulfills the ACA’s individual shared responsibility provision. If you qualify for Medicaid, you gain access to a range of mandatory benefits, which include inpatient and outpatient hospital services, physician services, laboratory and X-ray services, freestanding birth center services and more.[3]

What to know: Eligibility criteria for Medicaid varies by state. Some states expanded their Medicaid programs for low-income adults under the Affordable Care Act, while others did not. Visit medicaid.gov to learn more about Medicaid in your state.

Need help exploring your health insurance coverage options?

Call the number at the top of your screen to speak with a certified advisory, a health insurance producer who can work with you to determine what plan types apply to you and your life situation.

 


Legal Disclaimers

[1] HealthCare.gov. “Dates & Deadlines for 2016 Health Insurance.” Accessed June 25, 2016. https://www.healthcare.gov/quick-guide/dates-and-deadlines/

[2] Medicaid.gov. “Medicaid: Eligibility.” Accessed May 23, 2018. https://www.medicaid.gov/medicaid/eligibility/index.html

[3] Medicaid.gov. “Medicaid: List of Medicaid Benefits.” Accessed May 23, 2018. https://www.medicaid.gov/medicaid/benefits/list-of-benefits/index.html

This document is for general informational purposes only. While we have attempted to provide current and accurate information, this information is provided "as is" and we makes no representations or warranties regarding its accuracy or completeness. The information provided should not be construed as legal or tax advice or as a recommendation of any kind. External users should seek professional advice from their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.

SHORT-TERM MEDICAL EXPENSE (STM)
THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.