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Financial Help

What if I didn’t enroll by the January 31st deadline?

For most people, the last day to enroll in a health plan for 2016 was January 31, 2016. But, in some cases, you may still be able to get coverage this year.

If you have a certain major life change, you may qualify for a special one-time opportunity to enroll after the deadline. These changes include losing your health coverage, getting married, having or adopting a baby, moving to a new place, having a change in your income, or gaining citizenship. Learn more about all the life changes here and remember that you have to enroll no later than 60 days after the major change happens. We also encourage you to take advantage of free help (either in-person or by phone) from a trained LGBTQ-friendly assister to help you understand your options.

In addition, you may qualify for free or low-cost coverage depending on your income and your state. You can get this type of coverage – through Medicaid or the Children’s Health Insurance Program – at any time during the year. Unlike the Marketplace, there’s no deadline and you can apply at any time. You can get more information here or can get free help from a local expert.

Do I qualify for financial help?

You might – most people do. The amount of financial help depends on your income. You may qualify for financial help if your annual income is between approximately $11,700 and $47,000 (these amounts vary based on the size of your household). In fact, over 8 out of 10 people who enroll through qualify for financial help, and most people find plans available for $75 or less per month.

If you qualify, you will receive a tax credit that lowers the amount that you pay for insurance each month. Depending on your income, you may also qualify for cost-sharing reductions that lower the amount you pay in co-pays, deductibles, and other out-of-pocket costs. Learn whether you might qualify for financial help using this quick calculator.

Don’t forget that it’s the law to have health insurance. If you choose to go without coverage, you will have to pay a penalty of either 2.5 percent of your income or $695, whichever is greater. Since most people qualify for financial help, it may be cheaper to enroll in health insurance—and have the peace of mind that comes from being covered—than it is to pay the penalty.

Can I include my child when I apply for financial help?

Yes, if you claim your child on your federal taxes, you should list them on your Marketplace application, regardless of your legal relationship with the child.

Before you enroll, it is important to make sure the plan you pick covers you and your child together. This will depend on how the plan defines a “family.” You can usually find this information by looking at the “Evidence of Coverage” or the “Certificate of Coverage,” which is the full explanation of what is covered or excluded under each plan. If this information is not available, you may need to call the insurers in your state to see what type of coverage is available. We encourage you to take advantage of free help (either in-person or by phone) from a trained assister to help you consider your options.

If you cannot find a plan that covers you and your child, you may be able to enroll yourself and your child individually or check if your child is eligible for your state’s Medicaid program or Children’s Health Insurance Program. After you fill out your application, you’ll be told whether your child qualifies and notified by your state.

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