Q. I was laid off right before open enrollment ended, and now do not have any income/insurance. Am I still required to sign up for insurance by the end of open enrollment? What if I can’t afford it? I am looking for a new job, but it is going to take some time. What happens when I do get a job and receive health benefits again?
A: Losing your insurance because you were laid off counts as a qualifying event, so your open enrollment goes for 60 days from the date your old policy ended. If you want to purchase a new ACA-compliant plan, you’ll need to complete your enrollment within that time frame.
If your income remains low and you can’t afford coverage, you could qualify for a hardship exemption from the individual mandate, which would mean that you would not have to pay a penalty for remaining uninsured. In addition, you’re allowed to go two months without health insurance before the individual mandate penalty applies, so if you find a job that provides health insurance and you had a gap in coverage that lasted less than three months, you won’t owe a penalty regardless of your income.
Medicaid may be an option for you, depending on where you live. If you’re in a state that has expanded Medicaid, coverage is available if your income is under 138 percent of poverty level. If your state has not expanded Medicaid, eligibility is significantly more restricted. (Here are Medicaid eligibility guidelines for each state.)
Contact your state Medicaid office or the exchange to see if you could qualify for Medicaid until you get another job.
If you’re in the coverage gap because you’re in a state that hasn’t expanded Medicaid, you’ll have an opportunity to enroll in a subsidized health insurance plan through the exchange later in the year if you find a job that puts your income at or above the poverty level (assuming the job doesn’t come with health insurance and you need to purchase your own coverage). This is a new change that took effect in 2015.
Normally, a change in income does not count as a qualifying event. But for people who are in states that haven’t expanded Medicaid and are ineligible for Medicaid or premium subsidies because their income is below the poverty level, HHS made an exception to the rule. As of 2015, people in that situation are allowed to enroll in a subsidized exchange plan as soon as their income reaches 100 percent of the poverty level, regardless of when that happens during the year.
If you’re unable to afford an ACA-qualified plan while you’re between jobs, you might want to consider a short-term health insurance plan. These temporary health insurance plans are not regulated by the ACA, so they still use underwriting, don’t cover pre-existing conditions, cap benefits, don’t have to cover preventive care, etc. But they’re better than nothing and they’re far less expensive than an ACA-qualified plan. Short-term plans don’t meet the individual mandate requirements, but if you qualify for a hardship exemption, you wouldn’t be required to pay a penalty for having a plan that isn’t ACA-compliant.
If you get coverage on your own – either Medicaid or a private plan – and then get a new job that provides health insurance benefits, you’ll be able to cancel the interim insurance and switch to your employer’s plan once you’re eligible for coverage.