COLUMBIA, Mo. – Autumn means falling leaves and annual open enrollment through the Affordable Care Act’s health insurance marketplace.
The next enrollment period starts Nov. 1 and continues until Jan. 31, 2016.
To find the marketplace for Missouri, go to healthcare.gov and select Missouri, said Graham McCaulley, associate professor of personal financial planning for University of Missouri Extension.
While the enrollment period lasts until the end of January, you’ll need to be enrolled by Dec. 15 if you want your health coverage to start on Jan. 1, McCaulley said. If you sign up on Dec. 16 or later, your coverage won’t start until Feb. 1, 2016.
That cutoff applies whenever you enroll in a health plan on the marketplace.
“In general, if you sign up by the 15th of the month, your coverage will begin on the first of the following month,” said Brenda Procter, associate professor of personal financial planning for MU Extension.
It is also important to note that you’re not actually covered until you make your first month’s premium payment, McCaulley says. He suggests that when you’re ready to enroll, make sure you have bank or credit card information on hand so you can initiate that first payment.
If you went without health insurance in 2015, you might owe a shared responsibility payment when you file your taxes. If you were uninsured for the entire year, the fee will be $325 per adult and $162.50 per child, or 2 percent of the annual household income above the filing threshold, whichever is greater.
If you go without insurance in 2016, the fee will be higher.
“It’ll either be 2 1/2 percent of your annual household income that’s above the filing threshold, or $695 per adult, $347.50 per child under 18. You’ll pay the higher of those two amounts,” Procter said.
Procter says the penalty is based on the number of months you were uninsured, so you’ll owe less if you had coverage for part of the year. If you need help calculating the penalty, go to www.IRS.gov/aca.
The Affordable Care Act does offer exemptions from paying a penalty. Hardship exemptions include being homeless, having your individual insurance plan cancelled, or being ineligible for Medicaid because your state didn’t expand eligibility. You can find more information about exemptions at www.healthcare.gov/fees-exemptions.
“Someone could file for a hardship exemption based on a series of events connected to losing a job,” McCaulley said. “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,” McCaulley says. “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 healthcare.gov to get the documentation the Internal Revenue Service will require.
If you had a health insurance 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, so I recommend checking the marketplace to be sure you still have a plan that’s best for you,” Procter said.
For more information from the MU Extension Health Insurance Education Initiative, including videos, downloadable handouts and a schedule of informational sessions offered throughout the state, go to http://extension.missouri.edu/insure/families.aspx.