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HealthCare Checkup

The Seattle Times health-care team tracks the local impact of the Affordable Care Act.

May 28, 2014 at 2:19 PM

It’s not too late for many residents to get health insurance

Healthplanfinder promotion for its concert ticket sweepstakes.

Healthplanfinder promotion for its concert ticket sweepstakes.

After all the hubbub over the end of open enrollment for individual health insurance, state officials have a message for the uninsured: For many of you, it’s not too late.

That’s because there are  special circumstances that allow people — particularly younger people — to get insured throughout the year. The exemptions are mainly triggered by changes in someone’s family or work situation.

Officials with the state’s insurance exchange are trying to get the word out through a new contest to win free tickets for concerts, sports and other events.

People who can still enroll for insurance that begins in 2014 include those who:

  • Have or adopt a baby — and that new arrival qualifies the whole family for insurance.
  • Move to a new area with different insurance options.
  • Get married or divorced.
  • Lose a job with insurance.
  • Graduate and lose insurance provided to students.
  • Turn 26 and lose coverage through mom or dad.

For additional “qualifying events” and conditions for special enrollment, check out informational sheets from the Washington Healthplanfinder insurance exchange and the Office of the Insurance Commissioner. Residents have 60 days after the date of one of these events to enroll in an insurance plan. In most cases, people can buy their insurance through Healthplanfinder, or an independent insurance broker or insurance company.

People who already have insurance can change their coverage plans if they have a qualifying event.

Additionally there are folks who can sign up year-round. They include:

  • Those qualifying for Medicaid, which means earning up to 138 percent of the poverty level, or nearly $16,000 for an individual and $32,500 for a family of four.
  • Native Americans or Alaskan Natives.
  • Employers.

To make things extra complicated, small employers have even more insurance options than individuals shopping for coverage. They can buy insurance from brokers and insurance companies, and in Clark and Cowlitz counties they can use the state’s small-business exchange or SHOP. Or they can join an association or trust that serves their business sector — such as technology, builders, etc. — and purchase insurance through them.

For more on small-business options, check out my article from Sunday, including profiles on small businesses navigating these challenges.

The state is reminding residents about the special enrollment opportunities through a campaign primarily targeting young adults, considering that they’re more likely to have major changes in their work and relationship status.

Officials with Healthplanfinder had information booths at the Sasquatch! Music Festival over Memorial Day weekend, and signs promoting the health exchange will stay posted at the Gorge Amphitheatre throughout the summer. The exchange and music promoter Live Nation  launched a “Free Tickets for a Year” contest on Facebook to win a $5,000 Ticketmaster gift card.

For the insurance exchange to be sustainable in the long term, it needs to enlist hard-to-persuade populations, including young, healthy residents who are cheaper to cover because they use fewer medical services. In the initial enrollment period, 25 percent of those buying insurance were in the desirable 18-to-34 demographic, below the 28 percent President Obama cited recently as the national figure.

Residents who don’t qualify for special enrollment must wait until the next open-enrollment period for individuals, which runs Nov. 15, 2014 to Feb. 15, 2015.

Comments | Topics: Affordable Care Act, health insurance, Medicaid


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