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For Any Cancer Diagnosis

Q. Now that March 31 cut-off date for the Affordable Care Act has passed, how do people apply for health insurance? My dad had to go to the emergency room a couple of days ago and they suspect cancer. He has no insurance. How do we apply for help?

A.

Yes, Open enrollment for 2014 coverage is over, but you may still have options to get health coverage. Some of the options are:

  • You can still enroll in a private health plan through the Marketplace if you qualify for a special enrollment period. You can qualify for a special enrollment period if you have a qualifying life or an exceptional circumstance that prevented you from enrolling during the open enrollment period. A qualifying life event could include getting married, divorced, moving to a new area or losing other health coverage, for example. An exceptional circumstance includes a serious medical condition or natural disaster that kept you from enrolling and/or a systemic problem with the enrollment process during the open period. To learn more about the special enrollment period and what constitutes special circumstances, please visit www.healthcare.gov/sep-list. If you think that you qualify for a special enrollment period you can call the Marketplace Call Center at 800-318-2596 and speak with a representative to determine if your circumstances qualify.

  • There are no enrollment time restrictions for Medicaid and the Children’s Health Insurance Program (CHIP). In all states, Medicaid and CHIP provide health coverage for some individuals, families, and women, the elderly with certain incomes and people with disabilities. You need to check the Medicaid eligibility regulations of your state. A cancer diagnosis would constitute a disability. For more information about eligibility in your state please visit: www.healthcare.gov/do-i-qualify-for-medicaid/.

  • Private plans outside the Marketplace. In some limited cases, some insurance companies may sell private health plans outside the Marketplace and outside open enrollment that count as minimum essential coverage. These plans meet all the requirements of the health care law, including covering pre-existing conditions, free preventive care and not capping annual benefits. Insurance companies, agents, brokers and online health insurance sellers may offer these plans outside of the Marketplace. The Marketplace does not list or offer these plans nor can you get premium tax or lower out of pocket costs for plans you buy outside the Marketplace. To learn more, you can call insurance companies directly or work with an insurance agent or broker. Your state insurance department will know what companies are operating in your state.