Pushing deadline to get health insurance? Here's what you need to know

Do you want health insurance coverage that begins Jan. 1?

You must act quick.

Coloradans have until midnight Monday to enroll in health insurance through the state's new marketplace if they want coverage to start at the beginning of the new year.

This deadline was originally slated to be Dec. 15, but state regulators followed a decision by the White House to extend the deadline by eight days.

If you don't mind your coverage beginning later in the year, then don't worry: You have until March 31 to enroll in a plan. That's when open enrollment for 2014 benefits ends.

Here's a primer for navigating Monday's deadline.

How to get started

You're a little behind, so get started now.

Log onto www.connectforhealthco.com and create an account. If you don't want a federal subsidy - in other words, if you or your family makes more than 400 percent of the federal poverty level (about $45,500 for an individual or $94,000 for a family of four), then just purchase a plan.

If you think you might be eligible for a subsidy to help cut down your monthly insurance payments, keep reading.

You are beginning the subsidy application process

This process can be complicated.

Federal subsidies are only available with plans offered on Connect for Health Colorado. Subsidies are generally only available to people who don't quality for Medicaid - a program offering health coverage to primarily low-income Coloradans.

Almost everyone making less than 138 percent of the federal poverty level (about $15,000 for an individual or $31,000 for a family of four) can sign up for Medicaid.

Here's the catch: To ensure that people receiving subsidies aren't eligible for Medicaid, they first must apply for the program and be turned down.

For many Coloradans, receiving that denial has been difficult - even if they know they don't qualify for Medicaid. Medicaid officials had to streamline the application, because shoppers and insurance brokers said it was unwieldy and too long.

Also, shoppers didn't always get an automatic approval or denial once they completed that form - leaving their enrollment in limbo until Medicaid sent an answer. Sometimes, that process took weeks.

Last week, Medicaid officials reported they received as many as 1,700 Medicaid applications a day, said Rachel Reiter, a spokeswoman for the Colorado Department of Health Care Policy and Financing. The system sent automatic approvals or denials about 60 percent to 70 percent of the time.

But the remainder didn't get an automatic answer.

In those cases - which often were due to mistyped information on the forms - Medicaid officials had to personally review each case. Those officials have cleared 700 to 1,000 applications a day.

If you have applied for Medicaid and instantly received a denial, you can keep shopping.

If you applied for Medicaid and haven't heard back - or if you haven't tried filling out a Medicaid form yet - keep reading, because there's a work-around to get coverage that begins Jan. 1, according to Ben Davis, a marketplace spokesman.

The Medicaid work-around

In anticipation of a rush of people seeking Medicaid denials ahead of Monday's deadline, Medicaid officials asked people to finish the Medicaid application process by this past Friday.

In other words, if you're reading and you haven't tried to get a Medicaid denial yet, you might not get it by midnight Monday.

You can still apply - but there's no guarantee you'll get that denial in time.

However, there is a work-around option - though it could be expensive.

To tap this option, you must purchase a plan without a subsidy on Connect for Health Colorado.

Then, you can go back in late December or early January and try to receive a Medicaid denial - thereby, allowing the subsidy begin Feb. 1, instead of Jan. 1.

People who choose this route would get the entire subsidy applied to their 2014 premiums, Davis said.

For example, instead of someone's premiums being brought down by $80 a month over a 12-month period, a person would pay their full premium in January - then receive a $90 deduction over the span of 11 months.

You'd have to pay more money out-of-pocket for one month - an option that could cost some people hundreds of dollars - but you would also have coverage that begins Jan. 1.

You have enrolled in a plan

Just because you have enrolled in a health insurance plan doesn't mean your coverage is secured. You must pay your first month's premium - the monthly bill from your insurance company - to ensure coverage.

Typically, insurance companies require payment before activating a plan - meaning that those bills must be paid by Jan. 1.

If you haven't heard from your insurance company, though, you should verify that you are enrolled and that the bill will soon be sent.

Insurance companies in Colorado have agreed to allow people to submit their bills by Jan. 10 - a 10-day grace period that can prove helpful to people who don't receive a bill by the end of the year.

In this situation, people can see a doctor during that grace period - they just need to file a claim after the fact, and get reimbursed.

If you miss the deadline

If you don't get enrolled by midnight Monday, you can purchase health insurance for 2014.

The caveat: The soonest that coverage can begin is Feb. 1.

People who miss Monday's deadline have until Jan. 15 to enroll in a plan that begins in February.

And if you miss that next deadline, don't fear: Open enrollment will continue until March 31 for people who don't mind their coverage beginning later in the year.