From Nov. 1 to Dec. 15, around 4.7 million people signed up for health insurance coverage for 2018 through the Affordable Care Act, or Obamacare. 

If you weren't one of them, you've missed out on open enrollment. Open enrollment is a designated time each year during which insurance coverage can be purchased. Those who obtain coverage through employers have open enrollment periods set by company policy, but for most Americans buying insurance through Obamacare's exchanges, open enrollment ran only for this 45-day period from November to December. 

It's important to understand what the implications are in terms of your finances and your ability to protect yourself from the costs of unexpected health issues if you missed your chance to get covered for 2018. Here's what the end of open enrollment could mean for you. 

Doctor and patient discussing healthcare

Image source: Getty Images.

Is open enrollment really over?

If you've missed out on the federal open enrollment period, the first thing to do is find out if you live in one of the 10 states that extended the enrollment deadline to get 2018 coverage. These states, and their enrollment deadlines, include:

In every state, you can also sign up for Medicaid coverage or Child Health Insurance Plus (CHIP) at anytime throughout the year, if you're eligible for these means-tested benefits. 

If you're not eligible for extended enrollment, Medicaid, or CHIP, open enrollment is really over for you so you'll need to consider the implications. 

There's a small chance you could owe a tax penalty 

When Obamacare passed, the law included a penalty for those who opted out of purchasing insurance coverage. The penalty came in the form of the individual mandate. Penalties in 2017 totaled the lesser of $695 or 2.5% of modified adjusted gross income, so if you didn't have insurance this year, you'll have to pay. 

However, if you didn't sign up for 2018 coverage during open enrollment, whether you'll be penalized or not remains uncertain because the Republican tax reform plan included a repeal of the individual mandate. Tax reform is widely expected to pass with the mandate repeal included. If it does, you won't owe any extra money on your taxes in 2018 as a result of not being covered. 

Your ability to get coverage is now limited

Although you likely won't have to pay an Obamacare penalty, forgoing health insurance isn't a smart choice. If you have no insurance and face an illness or injury, you could find yourself drowning in medical debt. Unfortunately, now that open enrollment has come to an end, your ability to obtain coverage for 2018 is limited. 

Under the rules of Obamacare, you won't be permitted to purchase insurance on the Obamacare exchange until the next open enrollment period at the end of 2018, unless you have a qualifying life event that entitles you to take advantage of a special enrollment period. Examples of qualifying life events include:

  • Losing qualifying health coverage if you were covered by a plan that met Obamacare's requirements or received government-provided coverage through programs like Medicaid or CHIP
  • Getting married, getting divorced, having a baby, adopting a child, or having a foster child placed with you
  • A death in the family that causes you to lose health coverage 
  • Moving to a new zip code, moving from a foreign territory or country, moving to attend school, moving from a shelter or transitional housing, or moving to or from a location in connection with the performance of seasonal work
  • Becoming a United States citizen
  • Becoming a member of a tribe that is federally recognized
  • Becoming a shareholder in the Alaska Native Claims Settlement Act Corporation
  • Beginning or ending service as a VISTA member with AmeriCorps

In 2016, the Obama administration announced it would be tightening the rules regarding special enrollment to ensure those applying could provide documentation to prove eligibility.

The Trump administration was expected to continue to impose strict documentation requirements, and in February 2017, filed notice of a proposed new federal rule codifying new restrictions. This means that if you hope to get covered because of a qualifying life event, you will need proof. 

You may have options outside of Obamacare's policies -- but careful shopping is key

If you can no longer purchase an Obamacare-compliant insurance policy but still want some type of coverage, there may be options. However, not all the options are good ones. 

One option is to buy a short-term insurance policy. Short-term policies can be purchased throughout the year. Obamacare's rules, though, don't apply to these policies, so you can be denied coverage for preexisting conditions and the policy may provide limited coverage with substantial restrictions. 

Another possible choice is to look into a healthcare sharing ministry . A healthcare sharing ministry involves groups of individuals banding together to share medical expenditures. Many, but not all, ministries are organized through religious entities and require you to adhere to a specific set of religious beliefs in order to participate.

Health sharing ministries are not subject to Obamacare's requirements, so you can be denied coverage for preexisting conditions as well. Many ministries have coverage limitations, including a refusal to provide coverage for procedures considered morally objectionable. Ministries are also not subject to state insurance regulations, and there is limited or no oversight of operations, so it's important to do your research carefully to understand risks and coverage limitations.

Making sure you get covered

If it's too late to get covered through Obamacare this year, researching options for alternative protection is important so an illness or an injury doesn't cause financial devastation. You'll want to do everything you can to make sure you and your loved ones have a policy that provides the maximum protection possible. Whether this means finding a job that offers insurance or looking into alternatives like short-term insurance, it's worth exploring your options. 

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