The federal government is cracking down on what it sees as abuse of the special enrollment periods that allow some to sign up for Obamacare health plans after the open enrollment deadline.
However, it wants to let people know that there still are legitimate excuses to sign up for a marketplace policy outside of the normal timeframe.
But, as is often the case in life, distinguishing between legitimate excuses and frivolous ones is not always easy.
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For instance, while moving to a new state entitles you to sign up for a plan outside of the open enrollment period, it may be hard to figure out who's really moving.
The rules say that only those whose relocation is intended to be permanent qualify for the special enrollment provision.
"Individuals visiting an Exchange service area for a transitory purpose, for example, to attend to a business matter, obtain medical care, or for personal pleasure, do not have a present intent to reside, and do not meet the residency requirement for Marketplace coverage for the Marketplace service area they are visiting," CMS explained in a recent memo.
That means, for instance, that those who move for a period of time to a new location to receive treatment at a hospital do not necessarily qualify as residents of that state.
For those who may qualify as residents of more than one state, the guidelines suggest enrolling in a policy with a national network of providers.
The good news for those who do qualify for special enrollment is that there is no waiting period to sign up.
From the insurers' perspective, a waiting period might prevent abuse, since it would make it much harder for people to wait until they are sick to sign up for insurance, a phenomenon that insurers claim has become a problem.
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