What is the deadline to buy an ACA policy if I want it effective January 1?

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What’s the deadline to get coverage during Obamacare’s open enrollment period?

  • By
  • healthinsurance.org contributor
  • February 1, 2017

Q. What was the deadline to enroll in health insurance coverage for 2017?

Obamacare open enrollment guide

Our updated Insider’s Guide to Obamacare’s Open Enrollment offers time-saving strategies for selecting coverage during open enrollment. (Click the image for the latest edition.)

A.  Open enrollment for 2017 coverage is over. It began on November 1, 2016, and ended on January 31, 2017. (That’s the same schedule that was used for 2016 coverage, and it will also be used for 2018 coverage. But starting with 2019 coverage, the open enrollment window will be different, assuming current ACA rules are still in place)

The open enrollment window applied in the exchanges, and it also applied to plans purchased outside the exchange—with the exception of Nevada. (In Nevada, off-exchange plans—with no subsidies—can be purchased year-round, but the carriers can impose a three-month waiting period before coverage takes effect.)

January 31 was the last day to begin the enrollment process in 49 states and DC

For 2017 coverage, January 31 was the enrollment deadline in every state except Minnesota. But as was the case in prior years, HealthCare.gov asked people to leave their name and number during the peak time at the call center on January 31, and representatives will call those applicants later in the week and help them get enrolled in coverage.

But if you didn’t begin the process of enrolling by January 31, coverage is now only available for 2017 if you experience a qualifying event later in the year (see note below about the special rules that apply if your plan was terminated on December 31, 2016, and you found yourself without coverage on January 1).

Minnesota’s special enrollment period pushes deadline to February 8

The state-run exchange in Minnesota implemented a special enrollment period from February 1 to February 8. All residents in the state are eligible to enroll during this period, but only if they enroll through MNsure, the state-run exchange (off-exchange enrollments will only be available through January 31).

Minnesota’s special enrollment period was enacted in order to give residents enough time to take advantage of the new state-based premium rebate that lawmakers enacted in late January, to help offset premiums for people who don’t qualify for ACA premium subsidies.

Colorado and California give a few extra days to finish enrollments begun by January 31; HealthCare.gov will also help you finish the enrollment if you started by January 31

For people who began the enrollment process by January 31Colorado’s exchange will allow an extra three days to finish enrolling. The enrollment will have to be finished by 6pm (mountain time) on Friday, February 3.

And also for people who began the enrollment process by January 31, California’s exchange will allow an extra four days to finish. The enrollment will have to be completed by the end of the day on Saturday, February 4.

HealthCare.gov operates the exchanges in 39 states. Late in the day on January 31, their call center asked people to leave their name and number during the peak of the enrollment rush, so that a representative could call back later in the week to complete the enrollment process.

2017 penalty for being uninsured

The penalty for being uninsured doesn’t apply to people who have one short gap in coverage of less than three months time (note that the penalty does apply if you’re uninsured for three months or longer). If you enrolled in coverage by the end of January 2017 (or by the slightly extended deadlines mentioned above), you’ll have coverage in place no later than March 1, 2017. As long as you maintain it for the remainder of the year, you won’t face a penalty for 2017.

For people who remain uninsured, the penalty for not having coverage grew significantly in 2016. It will remain at the 2016 rate going forward, although the flat-rate amount will be adjusted annually for inflation (for 2017, the inflation adjustment is zero, so the flat-rate penalty will still be $695 per uninsured adult). Note that there are several circumstances under which you can get an exemption from the penalty.

After January 31, enrollment only available with a qualifying event

Now that open enrollment has ended, you’ll only be able to purchase coverage for 2017 if you experience a qualifying event that triggers a special enrollment period. In 2016, HHS tightened up the rules regarding eligibility for special enrollment periods. They also began conducting audits to ensure that special enrollment period regulations were being properly enforced, and that enrollees were providing proof of their qualifying events when they sign up. And they are planning to further enforce eligibility verification in 2017.

In short, the rules are being followed much more closely than they were in 2014. There will still be opportunities to obtain coverage for 2017 later in the year, due to qualifying events. But in most states, enrollees will have to provide proof of their qualifying events in order to complete the enrollment.

Special rule for loss of coverage

If you had a health plan that was terminated on December 31 for reasons other than non-payment of premium or fraud, you are eligible for a special enrollment period, as loss of coverage is a qualifying event.

If your plan ended altogether (which is not the same thing as simply being mapped to a modified plan) and renewal was not available, you have 60 days after your coverage ended to enroll in a new plan. (This is true any time a plan ends – even if it happens in the middle of the year, and the special enrollment period also extends for 60 days prior to the loss of coverage.) If your coverage terminated on December 31, your special enrollment period will continue until March 1.

An example of involuntary loss of coverage on December 31 would be anyone in Kentucky who had coverage through Kynect (the state-run exchange) in 2016, and failed to re-enroll through HealthCare.gov by the end of December 2016 in order to secure coverage for January 2017. People in that situation became uninsured as of January 1, and now have a special enrollment period that continues until March 1.

The special enrollment period triggered by loss of coverage allows for an effective date the first of the following month, even if you enroll on the final day of the month during your special enrollment period. So a person who lost coverage December 31 was able to enroll on January 31 and have coverage effective February 1 (despite the fact that under normal open enrollment period rules, the deadline to enroll for February 1 coverage would have been January 15).

Similarly, people who lost coverage December 31 and are not yet re-enrolled have until February 28 to enroll in a plan with a March 1 effective date. In order to take advantage of this provision, you’ll need to check the box on the application that says you’re enrolling because you lost coverage.