Have a health plan before you can’t buy one

With the end of open enrollment for individual and family health plans, many people do not understand that after March 31, you can not buy a health plan until the next open enrollment period scheduled to begin Nov. 15, for a Jan. 1, 2015, effective date. That includes on- and off-market plans.

In others words, you can not buy any plan either subsidized or unsubsidized from any insurance carrier.

This is completely different than in the past, when you could go to an insurance company anytime during the year and purchase a health plan at will.

After March 31, the market is closed to purchases and most people who have not purchased a health plan are then set to pay a penalty for not having acquired coverage.

Even if you have the misfortune of getting seriously ill, which could result in hundreds of thousands of dollars in medical bills, you can not buy a plan until Nov. 15, with a Jan. 1, 2015, effective date.

There are a few exceptions to this ruling, called “life-changing events,” that would allow one to purchase health insurance outside of the open enrollment periods.

Examples of qualifying life-changing events include moving to a new state, experiencing changes in your income and changes in your family size (for example, if you marry, divorce or have a baby), losing your employment or losing your employer’s sponsored health insurance coverage.

If you chose to pay the penalty and not purchase coverage until the next open-enrollment period, the earliest you can acquire coverage is Jan. 1, but again, you can not even apply for this coverage until Nov. 15 at the beginning of the next open-enrollment period.

We hope this provides some clarity to those who may not understand the complexity and time line of the law.

Gary and Barbara Smith,

Centers for Medicare and Medicaid

Services certified agents