What Do I Do If My Health Plan Is Being Cancelled?

If your health plan is being cancelled, here's what you need to know
Got a cancellation notice from your health insurer? Try to enroll in a new plan by December 15, but you can still get coverage after that.. Westend61/Getty Images

Hundreds of thousands of people across the country are currently enrolled in health plans that aren't eligible for renewal into 2016. If you're among them, here's what you need to do.

My Plan is ending. What do I do now?

If your plan is ending, rest assured that you'll still have coverage options for 2016. Prior to 2014 in most states, if a carrier pulled out of the market, there was no provision to allow their insureds to pick from any other plan on the market without medical underwriting.

But that's changed now that the ACA forbids medical underwriting. During open enrollment you have your choice of any plan available in your area.

Since general open enrollment is currently going on, your best option will be to select a new plan and finalize your enrollment by the regular enrollment deadline in your state. In all but three states, the deadline is December 15 to get a January 1 effective date (Health Republic enrollees in New York need to finish their first enrollment by November 15 to get coverage for December 1, but they will also need to select their 2016 plan - which may be different from the one they choose for December - by December 15).

What if I miss the December 15 deadline?

If your plan is ending on December 31 and you miss the December 15 enrollment deadline for picking a new plan, it's still possible to get a January 1 effective date, but the process may be complicated.

Because your plan is ending, you qualify for a special enrollment period. But the fact that the special enrollment period is concurrent with the general open enrollment period means that the technology involved might not function correctly. The enrollment systems are set up for general open enrollment right now, rather than special enrollment periods.

And while most special enrollment periods follow the same deadlines and effective dates as general open enrollment, that's not the case for special enrollment periods that are triggered by loss of other coverage

When loss of coverage triggers the special enrollment period, the new plan is effective the first of the month following the month when you enroll. So a person whose plan is ending December 31 could technically apply on December 31 and have coverage effective January 1. But this could be a complicated process, and should definitely not be something you plan to do. Again - the best course of action is to enroll in a new plan by December 15. But if your plan is ending and you miss that deadline, here's what to do:

  • Contact a broker, the exchange in your state, or the carrier you're using if you're enrolling off-exchange. You will need assistance with this process, and you'll want a paper trail in case there are glitches.
  • Make sure your enrollment is completed using a special enrollment period and NOT the general open enrollment period (which would push your effective date to February 1 if you enroll in the second half of December).
  • Be aware that you may need to complete a paper application, as some carriers may not have the technological capabilities to allow for an online special enrollment to occur during the general open enrollment period.
  • Be prepared for delays. If you enroll on December 31, you are obviously not going to have your new plan and ID cards by January 1. Your coverage will eventually be finalized and back-dated to January 1, but if you need care in January, you may have to pay for it up-front and seek reimbursement from your health insurance carrier.

Clearly, the best course of action is to enroll using the general open enrollment parameters, and finish by December 15. But if something comes up that prevents that, you'll still be able to get coverage for January 1, albeit with a few more hoops to jump through.

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