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Your guide to buying individual health insurance

Thanks to special enrollment periods, millions of Americans can still buy ACA-compliant plans

Louise Norris

Individual health insurance and health reform authority; broker

March 22, 2018

writer

2018 Obamacare enrollment

  • Open enrollment has ended, but consumers can still enroll if they are eligible for a special enrollment period.
  • Consumers are still required to have ACA-compliant coverage.
  • Premium and cost-sharing subsidies are still available.
  • Exchange plans are key to affordability.
  • Did you miss open enrollment? There’s a wide range of short-term coverage that could provide a temporary safety net.

With all of the hype about the importance of ACA’s annual open enrollment, it’s easy to understand why many Americans believe their opportunity to enroll in ACA-compliant coverage has now passed. But for millions, that’s simply not the case.

Millions can buy outside
of open enrollment

There’s actually a fairly long list of opportunities to enroll in ACA-compliant coverage outside of open enrollment. So before you give up hope on compliant coverage – and coverage that may very well include a subsidy – you should review our Insider’s Guide to Obamacare’s Special Enrollment.
The list of qualifying events that could result in a special enrollment period for you at any point during the year including:
  • A permanent move (in most cases, you must have also had coverage
    before your move)
  • Marriage or the birth or adoption of a child
  • Your non-calendar-year plan reaches its renewal date
  • A change in your ACA subsidy eligibility
  • A change in your citizenship status

READ MORE

If you’re eligible for a special enrollment period, you can still shop for ACA-compliant plans. Compare plans and premiums here by ZIP code.

Your reasons to enroll
haven’t changed

If you’re wondering whether it still makes sense to enroll, consider this:
  • You’re still required by law to have ACA-compliant health coverage. If you don’t, you could face the individual mandate penalty. Yes, the GOP tax bill included repeal of the individual mandate penalty, but that doesn’t take effect until 2019. People who are uninsured in 2018 will still face a penalty. Calculate your penalty.
  • Coverage is still guaranteed-issue, regardless of pre-existing conditions.
  • Premiums for older enrollees are still capped at no more than three
    times the premiums for younger enrollees.
  • And the financial assistance provided by the ACA is still available, with premium subsidies that are larger than ever in most areas of the country.

Four Americans who are still enrolling – like their live depend on it

Subsidies can still greatly reduce your plan costs

Depending on your household income, you may still be eligible for premium tax credits (aka, premium subsidies) and possibly cost-sharing reductions (CSR, aka, cost-sharing subsidies).
Premiums subsidies are still available in the exchange for people with income up to 400 percent of the poverty level. (For 2018 coverage, a single person can earn up to $48,240 and be eligible for the premium tax credit, and a family of four can earn up to $98,400). Calculate your subsidy. In 2017, 84 percent of exchange enrollees received premium subsidies that covered an average of two-thirds of the total premiums.
The only thing that has changed about premium subsidies for 2018 is that they’re larger than they were in 2017 in most areas, since average premiums increased and the subsidies grow to keep up with premiums.
Cost-sharing subsidies are also still available in 2018, even though the Trump Administration has eliminated funding for cost-sharing reductions. People with income up to 250 percent of the federal poverty level still have access to Silver plans with reduced out-of-pocket costs.
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