Top 10 Health Insurance Marketplace Questions - Wheaton Franciscan Healthcare

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Published on June 09, 2014

Top 10 Health Insurance Marketplace Questions Now that Open Enrollment is Over

  1. Can I still apply for Medicaid?
    Yes! Individuals and families can apply for Medicaid coverage throughout the year.
  2. Where can I find more information about the Wisconsin Medicaid program, BadgerCare Plus?
    Visit the BadgerCare Plus website. Additional information about how to apply is also available here.
  3. Can I still apply for commercial health insurance through the Marketplace?
    Generally you will have to wait until the next Open Enrollment Period. However, there are opportunities if you’ve had a life event – like getting married, divorced, having a baby, moving, or gaining citizenship. These events could mean you are eligible for a “special enrollment period.” Learn more about special enrollment periods.
  4. What if I lose my health insurance during the year? Can I apply?
    Yes. If you have coverage and at some point during the year are no longer eligible to receive that coverage, you can visit You can also contact an insurance agent/broker to help you. Examples of losing your insurance that allow you to apply include: no longer being eligible for Medicaid, losing coverage from an employer, or no longer being covered by a parent’s plan. In these cases the individual will only have 60 days from the day of the loss of insurance to purchase new insurance.
  5. Do I have to pay a penalty if I don’t have health insurance in 2014?
    Yes, individuals must have health insurance in 2014 or pay a penalty. This is sometimes referred to as the “individual mandate.” Learn more.
  6. Are there any exemptions from the requirement to have health insurance?
    Yes, there are exemptions based on income levels and certain hardships. For example, if you didn’t have health insurance on January 1, 2014 but applied for and received coverage by March 31, 2014 through the Marketplace, you would be eligible for an exemption from the penalty from January 2014 until the effective date of your coverage. Additionally, individuals who have a “short” gap in health coverage (less than three months) will not have to pay the penalty. See the full list of exemptions and hardships.
  7. What is the penalty for not having health insurance for 2014?
    The fee is either $95 (maximum of $285 for a family) or 1% of an individual’s income, whichever is greater. There is also a cap on the 1% penalty calculation, at the cost of the national average premium for a bronze level health plan available through the Marketplace in 2014. Find out more (PDF).
  8. How will the penalty for not having health insurance be paid, if applicable?
    The Internal Revenue Service (IRS) is responsible for collecting the penalty and they will be releasing detailed information later this year. Learn more (PDF).
  9. When does the next Open Enrollment Period begin?
    The next Open Enrollment Period will begin November 15, 2014. Note that plans won’t be effective until January 1, 2015.
  10. Where can find additional information?
    There are a number of websites that can provide helpful information:

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Top 10 Health Insurance Marketplace Questions Now that Open Enrollment is Over