Obamacare deadline 101: What if I haven't signed up yet?

Millions of Americans still haven’t signed up for health insurance, despite the individual mandate now in effect under Obamacare.  The deadline is March 31, but those who start the sign-up process by that date have extra time. Exactly how much is unclear. Obama administration officials liken the process to an election: If you get in line before the polls close, you’ll be allowed to vote.

So, if you are among the uninsured, what do you do? 

The easy answer is to go to HealthCare.gov, shop, and enroll. If your state has its own exchange, the federally run HealthCare.gov will steer you to it. If you have questions or don’t have a computer, you can call a toll-free number – 1-800-318-2596 – and an operator will help you.

The operator can also help you find a “navigator” – someone you can meet with in person to help you enroll. Navigators are individuals and organizations trained and paid by the government to help consumers understand their health coverage options and complete the forms.

Enrolling via paper application is also an option. Those claiming an exception for more time to enroll have until April 7 for the government agency running enrollment – the Center for Medicare and Medicaid Services -- to receive the paper application. Applicants who qualify for an extension will have until April 30 to pick a plan. 

Spanish speakers can get information and enroll at the Spanish version of HealthCare.gov, CuidadoDeSalud.gov. They can also reach Spanish-speaking operators at the toll-free number.

One doesn’t have to buy health insurance through a government exchange to have qualified coverage. People who are too young for Medicare and don’t get health coverage through their employers can also go to a private insurance agency, such as eHealth, at ehealthinsurance.com.

If you think you can’t afford health insurance, you may be wrong. The Affordable Care Act (ACA) provides federal subsidies on a sliding scale, based on income. HealthCare.gov has a chart showing the income levels, based on family size.

To access subsidies, one must enroll via a government exchange, either HealthCare.gov or one’s state exchange. Americans and legal residents with income below a certain level are eligible for Medicaid, a federal-state program that provides free or low-cost health care. States have the option of expanding access to Medicaid, and so eligibility requirements vary from state to state.

People under 30 and those with hardship exemptions may buy a lower-cost “catastrophic” health plan. Such a plan protects you from very high medical costs. (Hardship exemptions are listed on the website. Examples include eviction, the death of a close family member, and bankruptcy.)

“Catastrophic plans usually have lower monthly premiums than a comprehensive plan, but cover you only if you need a lot of care,” says the page on catastrophic coverage at HealthCare.gov. “They basically protect you from worst-case scenarios like serious accidents or illnesses.”

For a variety of reasons, some people don’t want to buy health insurance. But if they don’t have coverage, they could face a penalty, administered by the Internal Revenue Service. The first year, the penalty is $95 per person or 1 percent of family income, whichever is higher. The penalty goes up every year, and by 2016, is $695 per person or 2.5 percent of income. Every year thereafter, the penalties are adjusted for inflation.

The penalty will be waived if one’s income falls below a certain threshold. For example, someone who would have been eligible for Medicaid if their state had opted to expand access to the program would not face a penalty.  

HealthCare.gov lists eight exemptions from the penalty:

• You’re uninsured for less than three months of the year.
• The lowest-priced coverage available to you would cost more than 8 percent of your household income.
• You don’t have to file a tax return because your income is too low.
• You’re a member of a federally recognized tribe or eligible for services through an Indian Health Services provider.
• You’re a member of a recognized health-care sharing ministry.
• You’re a member of a recognized religious sect with religious objections to insurance, including Social Security and Medicare.
• You’re incarcerated, and not awaiting the disposition of charges against you.
• You’re not lawfully present in the US.

The exemptions page on HealthCare.gov includes links to forms for applying for an exemption.