CVIndependent

Sat09202014

Last updateWed, 27 Aug 2014 10am

Community Voices

Editor's Note: While the Independent has a policy against running press releases, we've agreed to run this piece from Covered California, as it contains important information about the availability of health insurance—which can be a life-changing situation. 

Despite the best-laid plans, life can sometimes throw you a curveball.

So it is with health care.

After months of planning, promotion and outreach, Covered California successfully completed its first open enrollment period of the historic Patient Protection and Affordable Care Act—helping more than a million consumers gain health insurance coverage.

Some people, however, may have had a change in life circumstances since open enrollment ended on March 31, and suddenly, they have a new need for coverage. If so, the door is not closed. They can still gain coverage through Covered California’s special-enrollment option.

“We continue to remind people that we still are open for business,” said Covered California executive director Peter V. Lee.

Through Nov. 15, 2014, consumers can sign up for health insurance as long as they do so within 60 days of a qualifying life event. The following circumstances are among the more common reasons that make someone eligible:

• They lose their health care coverage because they’ve lost or changed jobs.

• They lose their Medi-Cal coverage.

• They get married or enter a domestic partnership.

• They have a baby, adopt a child, or place a child in adoption or in a foster home.

• They move and gain access to new Covered California health insurance plans that were not available where they previously lived.

• They become a citizen, national or lawfully present individual.

For other examples that may qualify you for coverage through special enrollment, visit www.CoveredCA.com/coverage-basics/special-enrollment.

You must report changes and select a plan within 60 days of the qualifying life event to purchase a Covered California health insurance plan outside of open enrollment. Medi-Cal is available all year, however, and no qualifying life event is required to enroll in Medi-Cal.

If you have additional questions about whether you qualify for a special-enrollment period, you can call the Covered California Service Center at (800) 300-1506.

How do I avoid gaps in coverage?

You will need to plan ahead to avoid gaps in health coverage. It helps to know that in general, the start date for coverage depends on the date you enroll. If you enroll by the 15th day of the month, your coverage will start on the first day of the next month. If you enroll after the 15th day of the month, your coverage will start on the first day of the second month. For example, if you enroll on Aug. 13, your coverage will start Sept. 1. If you enroll on Aug. 16, your coverage will start Oct. 1. You can use this rule as a guideline to help plan your new coverage and avoid gaps.

(Note: If you go without coverage for three consecutive months during the year, and you don’t fall under an exemption permitting you to do so, you will be subject to a tax penalty.)

For most qualifying life events, the start date for coverage depends on the date you enroll, as described above, but there are a few exceptions:

• If you lose your Medi-Cal coverage, job-based coverage or other coverage, and you use a special-enrollment period, your coverage would start on the first day of the next month following your plan selection, regardless of when during the month you make your plan selection.

• If you get married and use a special-enrollment period, your coverage will start on the first day of the next month following your plan selection, regardless of when during the month you make your plan selection.

• If you have a child, adopt a child or place a child in adoption or foster care, and you use a special-enrollment period, your coverage starts on the date of the birth, the adoption or the placement for adoption or foster care.

• On a case-by-case basis, Covered California may start your coverage earlier.

Larry Hicks is the public information officer for Covered California.

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