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December 2018 E-News from Texas Insurance & Financial Services INSURANCE

What to do if you miss the open ACA registry?

Although the Tax and Employment Act effectively removes the tax penalty if there is no health insurance; Individual plans are still an important protection against unexpected medical bills. In addition, they cover many preventative measures, such as annual wellness visits and vaccinations.

However, the open enrollment deadline, in which insurance companies have to accept you regardless of previous conditions, was shorter this year than in previous years and ran from 1 November to 15 December. If you miss your enrollment deadline, you may still have options.

Special registration deadlines
First, you can qualify for a special enrollment deadline (SEP). This may apply if you are going through a qualifying life event. If you qualify for a SEP, you have up to 60 days after the event date to complete individual health insurance under the Affordable Care Act. Examples of qualified life events are:

  • Marriage, divorce, childbirth, death in the family or adoption
  • change of residence
  • Loss of health insurance (ie dismissal from employment)


You can also qualify for a 60-day SEP if one or more of these qualifying life circumstances apply:

  • You become an American citizen
  • They are released from custody
  • You are losing eligibility for Medicaid or the Child Health Insurance Program


group plans
If you do not qualify for a SEP, you may be able to obtain an ACA-qualified health insurance by becoming an employee of a company sponsoring a group health plan.

Generally, during an initial enrollment period, you can enroll in your employer plan, which can be done at any time of the year. As long as you take the opportunity to register for the initial admission, you do not have to wait until the annual registration deadline for the first open registration deadline set by your employer.

Short-term health plans
If necessary, you may qualify for a short-term health insurance (STM). These offer a very simple insurance cover that varies from state to state for a limited period of time. The federal regulations now provide for up to 364 days and up to three extensions, but many states issue much more restrictive guidelines.

STM plans generally include emergency rooms, hospitalization, laboratory and x-ray fees, and outpatient surgery. They exclude preventive services and prescription drugs, except during hospitalization.

STM plans are not ACA compliant. They offer less coverage and often exclude existing conditions. There is no guaranteed spending provision, which means that freight forwarders can refuse you based on your medical history.

Although these plans are not a substitute for an ACA-compliant policy, they may be useful if you are in between two jobs or waiting for a qualifying life event or open enrollment deadline.

Critical Illness Insurance
You may also be able to take out critical health insurance. This will pay you a one-time cash payment if you have a policy-covered illness such as cancer diagnosed. While you may expect a review of medical records and possibly a medical check-up, there is no open enrollment deadline for these plans, and you can enroll them at any time during the year.

If you do not have an open registration deadline this year, do not give up! Nevertheless, you should protect yourself as much as possible from unexpected medical expenses. Call us today and let us help you explore your options.

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