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Consider Checking Out Options During Open Enrollment

For Some, It’s That Time of Year Again…

Autumn means two things: falling leaves and the annual open enrollment through the Affordable Care Act Marketplace. This year the enrollment period will start November 1, 2015 and continue until January 31, 2016.

The Affordable Care Act created the Missouri Health Insurance Marketplace. To find it, go to and select Missouri, which will take you to the state’s health insurance marketplace.

If you want your health coverage to start on January 1, 2016, you’ll need to be enrolled by December 15, 2015. If you sign up on December 16th or later, your coverage won’t start until February 1, 2016.

That 15th of the month cutoff applies whenever you enroll in a health plan. In general, if you sign up by the 15th of the month, your coverage will begin on the first of the following month. If you sign up on the 16th or later, you’ll have to wait until the month after that.

It is important to note that although you may be enrolled for the purposes of avoiding a tax penalty, you’re not actually covered until you make your first month’s premium payment to the insurance company. So, when you’re ready to enroll make sure you have banking or credit card information so you can initiate that first payment.

It’s important to make you have insurance for many reasons, but a big motivator for some may be to avoid the fee for not having coverage. As we enter 2016, those without insurance could pay a fee for every month over three months that you were without health insurance. That fee will be
either be 2.5%  percent of your annual household income that’s above the filing threshold or a flat fee of $695 per adult ($347.50 per child under 18), whichever is higher. However, the penalty is calculated month-to-month, so you only pay for those months when you were uninsured.

The Affordable Care Act does offer exemptions from paying a penalty. Some of the hardship exemptions include being homeless, having your individual insurance plan cancelled, or being ineligible for Medicaid because your state didn’t expand eligibility for Medicaid.

Someone could file for a hardship exemption based on a series of events connected to losing a job. But, just losing a job isn’t necessarily going to be a trigger for getting an exemption.

For example, if someone worked half of the year, and then collected unemployment for the other half, combined wages and unemployment could put them above the poverty line and they would not get an exemption.

You don’t have to have a job to get coverage through the Marketplace. Estimate what you’ll earn for the year, both wages and unemployment. You could get a tax credit that makes insurance very affordable.

If you think you may qualify for an exemption from paying a fee, you will need to go to to get the documentation that the Internal Revenue Service will require.

If you had a healthcare plan in 2015, you will be automatically renewed to a plan that is “most similar” to your existing plan, but comparison shopping is still a good idea. Prices, networks and other things might change, and checking the Marketplace to be sure you still have a plan that’s best for you is a good idea.

If you are interested in learning more about what type of health insurance plans may be available to you through your state’s Health Insurance Marketplace, or if you want to ask about an exemption from the individual mandate, a good place to start would be;

– Graham McCaulley and Brenda Procter
University of Missouri Extension Health Insurance Education Initiative (