5 Big Risks of Missing the December 15 Obamacare Deadline

Affordable Care Act

5 Big Risks of Missing the December 15 Obamacare Deadline

Published on December 16, 2015

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Updated May 14th, 2019
The Affordable Care Act (ACA/Obamacare) created nationwide open enrollment periods when anyone can apply for major medical health insurance.
The open enrollment period is in full swing, but just like last year, you only have so much time to enroll.  The deadline to purchase health insurance that will start on January 1st 2020 is approaching. If you don’t shop and apply before December 15th 2019, you could miss out on coverage for the new year.
This means, uninsured Americans who miss the December 15 deadline may not be able to get coverage unless you experience a qualifying life event.   While you will not incur a federal tax penalty for not having coverage from 2019 on, there are still penalties in some states and you do run the risk of getting hit hard by the cost of unexpected healthcare expenses.
Here are some of the risks you run by missing the open enrollment period for Obamacare:

5 Big Risks of Missing the December 15 Obamacare Deadline

  • You may find yourself uninsured on January 1.  If you don’t qualify for Medicaid or the Children’s Health Insurance Program (CHIP), which don’t have open enrollment periods, or qualify for a special enrollment period if you have a qualifying life event, you may find yourself without coverage in the new year.
  • Your healthcare costs may increase significantly. If you go uninsured in the new year, you may experience a significant increase in healthcare costs. Going without coverage could mean that you have to pay full price for any healthcare you receive which could certainly be a large price if you suffer from a medical injury during your time being uncovered.
  • You may no longer get subsidies on January 1. If you’re currently receiving subsidies and didn’t authorize your 2019 subsidy to be automatically recalculated for 2020, according to healthcare.gov, you may stop getting government help with your premiums on January 1. Make sure to check your health insurance plan details, and educate yourself on the limitations of government subsidies. If your annual income has significantly changed, you should also look into how this can affect your subsidies.
  • Your prescription drugs and preferred doctors may no longer be covered. If you go without coverage in the new year, you may not be able to access your preferred prescription drugs or healthcare providers at an affordable rate.
  • You may have to settle for a plan with less benefits. Open enrollment for 2020 health plans is scheduled to go from November 1st, 2019 through December 15th, 2019. However, if you miss the December 15 deadline, and you don’t qualify for Medicaid, CHIP, or a special enrollment period your only option may be health insurance that does not have restrictions on enrollment. Short term health insurance typically runs from 3 months to a year depending on where you live. However, short term health insurance does not provide the same level of coverage as major medical plans.

5 Tips for Shoppers As Open Enrollment Approaches

To help health insurance shoppers avoid the risks that come with missing the December 15 deadline and assist them in finding the right health plan for their personal needs and budget, eHealth offers the following tips:

  • Review your medical care and prescription drug usage from 2019. It’s important to understand the kind of medical coverage you may need in the new year. Think about how often you received care this year and ask yourself the following questions:
    • Do you have any chronic conditions?
    • Do you use prescription drugs on a regular basis? How often do you see the doctor?
    • Do you plan on scheduling any major medical procedures in 2020?
  • Look beyond premiums when considering new plans.  It’s important to consider more than the monthly costs of health insurance. While it may be attractive to purchase a plan with a low premium and a high deductible, it may be more cost-effective for your needs to get a plan with a higher premium and a lower deductible. Make sure that in a worst-case scenario you can afford the deductibles, copayments, and coinsurance requirements of any new plan you’re considering.
  • Know the pros and cons of subsidy eligibility. The Affordable Care Act makes government subsidies available to qualifying consumers with income from 100% of the federal poverty level (According to the US Department of Health & Human Services the 2019 FPL is $12,490 for a single person or $25,750 for a family of four) to 400%. Subsidies can make coverage more affordable. However, if you accidentally earn a bit more than expected during the year (and do not report any change in income), you may find yourself no longer eligible for subsidies and required to pay them back when you file your federal tax return for 2020.
  • Find out if new plans will cover your drugs and preferred doctors. Some of us have favorite doctors or local hospitals that we prefer to visit. Others have prescription drugs that we take on a regular basis. Make sure that any new health insurance plan you’re considering includes your preferred doctor or hospital in its network of providers, and that the drugs you need are covered at an affordable copayment.
  • Look beyond government-run exchanges for more coverage options. The government-run exchange in your state is not your only resource during open enrollment. Private online marketplaces like eHealth can offer many shoppers access to the exact same health insurance plans (and government subsidies) in many states, plus access to additional Obamacare-compliant plans that aren’t available on government-run exchanges. Start comparing plans available in your area with eHealth by entering your zip code on the right side of this page.

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