Health Insurance Special Enrollment Available for Those Affected by Hurricanes

Health Insurance Special Enrollment Available for Those Affected by Hurricanes | HealthCare.com

If you were personally affected by the hurricanes or the California wildfires, you may have additional flexibility in applying for health insurance.

Hurricanes Harvey, Irma, and Maria in August and September 2017, along with the California wildfires that followed in October, upended the lives of millions of Americans. With so much loss and confusion in the aftermath of natural disasters, individuals and families shouldn’t have to face additional hurdles to figure out health coverage options during this open enrollment period.

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Healthcare is an important part of getting “back to normal.” As of September 28, the federal government declared that healthcare relief is available for those in hurricane-affected areas. Those affected by the California wildfires may also seek relief. Most of the relief involves giving you more time to figure things out.

Here’s what the natural disaster relief guidelines say in plain English.

Natural Disaster Health Insurance Relief for Those with Individual Health Insurance (Obamacare)

Who Is Eligible?

The emergency health insurance enrollment rules leave some room for flexibility – they changed several times, even as late as mid-October. If you have issues related to any natural disaster, wherever you are in the country, you’re encouraged to call a health insurance broker and see what can be worked out.

If you lived in the following counties during a hurricane – OR if you live there now – you are definitely eligible:

Florida: All 159 counties are eligible.

Georgia: All 67 counties are eligible.

Louisiana: Of Louisiana’s 64 parishes, 20 are eligible: Acadia, Allen, Assumption, Beauregard, Calcasieu, Cameron, De Soto, Iberia, Jefferson Davis, Lafayette, Lafourche, Natchitoches, Plaquemines, Rapides, Red River, Sabine, St. Charles, St. Mary, Vermilion, Vernon.

Texas: Of Texas’ 254 counties, 53 are eligible: Aransas, Austin, Bastrop, Bee, Brazoria, Burleson, Caldwell, Calhoun, Chambers, Colorado, Comal, Dallas, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Grimes, Guadalupe, Hardin, Harris, Jackson, Jasper, Jefferson, Jim Wells, Karnes, Kleberg, Lavaca, Lee, Liberty, Matagorda, Milan, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Robertson, Sabine, San Augustine, San Jacinto, San Patricio, Tarrant, Travis, Tyler, Victoria, Walker, Waller, Washington, Wharton.

South Carolina: Of South Carolina’s 46 counties, 16 are eligible: Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Charleston, Colleton, Dorchester, Edgefield, Georgetown, Hampton, Jasper, McCormick, Oconee, Pickens.

What You Get

1. 16 Additional Days During the 2018 Open Enrollment: In most states, you’ll only have 45 days to sign up for next year’s health insurance plans. This 45 day sprint, which lasts from November 1 to December 15, 2017, is called the Open Enrollment Period.

If you were affected by a hurricane, you’re also eligible for an “Exceptional Circumstances Special Enrollment Period” that lasts from December 15 through December 31. This effectively extends the time you can buy 2018 health insurance without penalty by an additional 16 days, through the end of 2017.

If life circumstances leave you without insurance after open enrollment, you’ll have additional time to make an enrollment decision. You’ll still want to sign up for a plan as soon as possible – waiting until after December 15 won’t affect your coverage or what you pay, but it will be more of a hassle to enroll.

2. The Possibility to Make Changes to Your Current Coverage: Hurricane relief is available if you’d like to make changes to your 2017 health insurance.

To prevent people from waiting to sign up until they’re sick, health insurance plans only enroll new members during a 45-day Open Enrollment Period each year. However, life changes can qualify you for a Special Enrollment Period. Special Enrollment Periods – which let you purchase new health insurance or change your existing plan without penalty – can take place at any time of the year.

Hurricanes can cause a number of special enrollment circumstances. If you move to a new zip code, or your employment status changes, you qualify for special enrollment and can enroll in a health plan as if it was open enrollment again.

Americans faced with the unusual circumstance of not completing their health insurance enrollment during a natural disaster have additional support available. If you experienced a special enrollment qualifying event between 60 days prior to the hurricane and December 31, 2017 – and you had already started to apply before being affected by a natural disaster – then you can use that special enrollment eligibility, which typically only lasts 60 days, for an additional 60 days. The health insurance plan you buy can be retroactively dated to start as early as the date of the hurricane, helping you pay for medical services you’ve already used.

3. You Can Claim a Hardship Exemption for 2017 Taxes: You can cancel your health insurance coverage and ignore the tax penalty for not having coverage (also called the individual mandate), by claiming the “hardship exemption”. The Department of Health and Human Services has encouraged those without health insurance – or those who wish to go without health insurance as a result of the hurricane – to claim the exemption.

4. Additional Time to Catch-Up on 2017 Monthly Premiums: You usually have 30 days after your coverage starts to make your first monthly health insurance payment. Your insurance plan can also disenroll you after 3 months without payment.

However, hurricane guidelines permit your insurer to give you an additional 60 days to pay monthly premiums and bills. If your insurer allows this, then you may have already received a letter letting you know about this option. If you haven’t heard from your insurer, then you’ll need to contact your health plan to confirm that this relief is available.

5. Texas Out-of-Network Care: If you’re a Texas resident who received out-of-network care due to a hurricane, your insurance can treat it as in-network, covered care. Texas is also accepting all doctors in good standing to treat patients across the state, even if the doctor isn’t licensed in Texas.

How to Get It:

  1. Call Healthcare.gov: To select or change a health plan for 2017 at any time – or to use the Exceptional Circumstances Special Enrollment Period for 2018 between December 16 and December 31 – those affected by natural disasters can contact Healthcare.gov’s call center at 1-800-318-2596.
  2. Gather Personal Documents: Although changes made to Healthcare.gov in 2017 may require you to submit inconvenient amounts of personal documentation to enroll, calling 1-800-318-2596 to enroll for hurricane-related reasons will excuse you from these requirements.
  3. Be Prepared for Uniformed Healthcare.gov Representatives: You may have to argue and provide supporting evidence to agents on the Healthcare.gov call line. When we attempted to enroll in a 2017 plan as if we needed hurricane relief, we were stunned to hear our first call center representative say that they “had no details” about Healthcare.gov’s policy, and would not be able to enroll someone affected by a hurricane.

We are proud to report that HealthCare.com’s call center partners, on the other hand, will remain well-informed about health insurance for hurricane victims during open enrollment.

Natural Disaster Medicare Enrollment Relief for Medicare Beneficiaries

Who Is Eligible?

The Medicare relief exemption is more expansive than the comparable disaster relief rule for Americans who rely on Obamacare health insurance.

The geographic area in which this relief applies is not clearly defined. Medicare is extending it to anyone involved in a “weather related emergency or major disaster” – which generally means Texas, Florida, and Georgia, Puerto Rico, and the U.S. Virgin Islands – but also could extend to South Carolina, Louisiana, California, or elsewhere.

Additionally, if you don’t reside in an affected area but “rely on help making healthcare decisions from friends or family members” who do live in an affected area, then you’re eligible.

What You Get

1. You Can Change Your Medicare Advantage or Part D Coverage: You’re eligible to enroll in, switch, or leave a Medicare Advantage or Medicare Part D Prescription Drug plan by asking for a “weather-related Special Enrollment Period.” Special Enrollment Periods also extend to those who would apply to lesser-known programs such as PACE plans, Medicare Cost plans, Medication Therapy Management programs, and Medicare demonstration or pilot programs.

The Special Enrollment Period for Medicare beneficiaries who were affected by weather-related events will last through December 31, 2017 (this overlaps with the Medicare Annual Election Period in which everyone can change Medicare Advantage or Part D coverage, which lasts from October 15 to December 7 each year).

2. You Can Enroll in Original Medicare without Hassle: Those who didn’t enroll in Medicare Part A or Part B due to a weather-related event may also be able to extend their enrollment window to December 31 using the Special Enrollment Period.

This relief extends existing enrollment periods – you cannot become eligible for penalty-free Part A, for instance, if your enrollment period passed before you were affected by a weather-related event.

3. Enrollment Takes Effect Quickly: Plan changes and enrollments to new plans will be effective on the first day of the following month, including for those enrolled after the Annual Election Period.

4. Other Special Enrollment Periods May Exist: Many people also qualify for a special enrollment period for a number of hurricane-related reasons, such as moving to a new zip code or losing employment.

5. Fewer Barriers for Doctors: According to MedLearn Media, a significant amount of Medicare paperwork is still waived for doctors in the affected areas, making it easier for doctors to provide care.

How to Get It (Medicare, Part C, and Part D):

You can shop for Medicare Advantage or Part D Prescription Drug coverage, including at HealthCare.com and MedicareGuide.com. You can call the federal Medicare hotline at 1-800-633-4227.

You should call 1-800-633-4227 if you had to put off Part A or Part B enrollment due to recent disasters.

How You Can Help Others

The American Red Cross is collecting donations to support those affected by all three major hurricanes and the California wildfires. As of writing, you can specify which fund you’d like your donation to go to.

There are of course other non-profit and government relief programs available apart from health insurance. You can visit www.disasterassistance.gov to start looking for other aid available to you.

Taking the Next Steps

Approximately 20 million people will shop for health insurance during this Open Enrollment Period. If you’re shopping for healthcare coverage on your own, check out HealthCare.com to see what Marketplace and off-Marketplace plans are available to you.

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Search our database of individual health insurance plans at HealthCare.com.

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Hal Levy

About Hal Levy

Hal is a staff writer at HealthCare.com, where he monitors the insurance industry and helps consumers make smart medical decisions. Prior to joining HealthCare.com, Hal worked at other rapidly growing startups and nonprofit groups. He drinks a ton of coffee and eats vegetables almost every day.

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