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Merry Christmas! Did You Sign Up for Obamacare, or Are You Out of Luck?

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If you did not sign up for health insurance by Christmas Eve this year, you are not out of luck. You can still get insured. With all the news about the Obamacare website, the deadlines, the delays, you would think that would be clear. But it could not be more confusing.

For the relatively small number of people in the US who buy their own insurance, or would like to, there are some important deadlines you should know about. Although the deadline for enrolling and getting insurance coverage by January 1 in a federal or state exchange has passed, you can still enroll after the deadlines. You just won't be covered right on Jan. 1, 2014. In fact, until March 31 of 2014, there are no specific deadlines that would keep you from getting health insurance if you sign up. (However, check your local state exchange for any other deadline information to be sure).

For example, if you apply for insurance in the first half of February next year and pay your premium, you will be covered the first of March. If you wait until the second half of February, your coverage may be delayed until the beginning of April. But the point is -- you can still get insurance. And that insurance will include all the protections of the Affordable Care Act.

There is one very important deadline -- March 31, 2014. After that date, if you don't have health insurance, you will pay a tax penalty of 1 percent of your income or $95, whichever is greater (and the amount goes up steeply in later years), even if you buy insurance later in the year. Also, if you want a federal subsidy to help you pay for insurance, you won't be able to enroll in a state or federal exchange plan after that date unless you qualify for a "special enrollment period." These periods are only applicable to people who have special life events like getting married, losing your other coverage, moving to another place, etc.

However -- and this is one of the confusing things -- you can apply directly with a health plan for coverage "outside" the exchanges any time after March 31. The next formal "open enrollment" period for getting health insurance through a state or federal exchange (and possibly qualifying for a subsidy) will be Nov. 15, 2014, through Jan. 15, 2015. If you do apply directly with an insurance company after March 31, you will still pay the tax penalty and forfeit any subsidy, but you can't be turned down for a pre-existing condition and the same services that are covered in exchange plans will be included in what you buy.

Why has there been so much hype about the December deadline, then? Actuaries and policymakers worry that if there is no pressure to enroll, people will put it off. Also, they worry that the healthy people will put it off, leaving only sick people in the pool of the insured, thus potentially driving up costs the next year. Whatever the reasons, it is likely that the sickest will sign up anyway, and the healthy will wait until they absolutely have to do it or their mother forces them.

So why should you sign up now? Why not wait until you get sick? Because unless your illness is planned (and whose is?), you won't be covered for it while you wait for your coverage to "kick in." If you have a bicycling accident on April 17, even if you apply the next day and pay your premium, you may not have coverage for any medical care until June 1, and your accident won't be covered anyway. Since it's unlikely that you can predict any illness or accident, better to plan ahead.

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