Health Insurance Basics

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Open enrollment has ended, but you can still get insured
in 2014.

After April 1, 2014, you can still enroll in health insurance, if you meet certain criteria.

Medicaid or C.H.I.P.

You can enroll in Medicare or the Children's Health Insurance Program (C.H.I.P.) year-round.

Qualifying Life Event

Qualifying life events include:

  • moving to a new state
    moving to a new state,
  • certain changes in income
    certain changes in income that impact a household's eligibility for a tax
    subsidy or cost-sharing reductions,
  • loss of qualified coverage
    loss of qualified coverage
  • and changes to family size/structure
    and changes to family size/structure (e.g., marriage, divorce, birth of a
    baby, adoption of a child, change in citizen status, and government

Special enrollment periods for qualifying life events generally last 60 days from
the date the event occurred.

Complex Cases

You may be eligible for enrollment at this time if you:

  • tried and thought you had enrolledtried and thought you had, enrolled during the open enrollment period,
  • tried and thought you had enrolleddiscover a material error in the coverage offered by the plan in which
    you enrolled, or
  • were incorrectly advised that you were eligiblewere incorrectly advised that you were eligible to enroll in Medicaid.

Short-Term Health Insurance Plan

If you don't have insurance, and don't qualify for any of the above exceptions, you
can purchase a short-term plan to bridge the gap between now and the next open
enrollment period, which starts on November 15, 2014.

What Is Covered?

All health plans must provide coverage for all of the following categories of care1:

  • Ambulatory patient services
    Ambulatory patient services (outpatient care you get without being
    admitted to a hospital)
  • Emergency services
    Emergency services
  • Hospitalization
  • Maternity and newborn care
    Maternity and newborn care (care before and after your baby is born)
  • Mental health and substance use disorder services
    Mental health and substance use disorder services (this includes
    counseling and psychotherapy)
  • Prescription drugs
    Prescription drugs
  • Rehabilitative and habilitative services
    Rehabilitative and habilitative services (services and devices to help
    people with injuries, disabilities, or chronic conditions gain or recover
    mental and physical skills)
  • Laboratory services
    Laboratory services
  • Preventive and wellness services and chronic disease management
    Preventive and wellness services and chronic disease
  • Pediatric services
    Pediatric services

What If I'm Not Insured Today?

You need to enroll in coverage, or you may be subject to a fee. Open enrollment has ended for 2014, but you can still obtain health insurance if you meet certain qualifying exceptions, such as those listed above.

1Coverage for these services is what the new law considers to be the Essential Health Benefits (EHBs).