Health Insurance Open Enrollment and Enrollment Waivers

You may qualify for health insurance, even when enrollment is closed.  Contact the Health Connector, a health insurance company, or a health insurance agent for more information.

Special Notice about the Health Connector:  If you had trouble applying for insurance from the Health Connector, you can contact the Health Connector until April 15, 2014 to buy insurance without an enrollment waiver.

Many individuals and families buying health insurance on their own (not through their employers) can buy health insurance during an open enrollment period.

The 2014 open enrollments periods are:

January 1, 2014 - March 31, 2014
November 15, 2014 – February 15, 2015

Massachusetts and federal law limit when you can buy certain health insurance plans. Some people may meet special conditions and can buy insurance at any time.  Others must buy insurance during the open enrollment periods.

Who can apply for an enrollment waiver?

If you are a Massachusetts resident and missed the open enrollment period, then you might qualify for a waiver of the open enrollment period if you meet certain criteria. During 2014, the Office of Patient Protection will accept applications for enrollment waivers from April 1, 2014 until November 18, 2014.  If you had trouble applying for insurance from the Health Connector during open enrollment, you can contact the Health Connector until April 15, 2014 to buy insurance without an enrollment waiver.

You may qualify for an enrollment waiver if you meet applicable eligibility criteria and (for example):

  • You are uninsured and did not intentionally forgo enrollment in health insurance; or
  • You applied for MassHealth or other subsidized coverage, and found out that you were denied after 63 days had passed; or
  • You lost insurance coverage but did not find out until after 63 days had passed

You must first apply for coverage to a health insurance plan or agent and be turned down before you can apply for an enrollment waiver. You can apply for insurance on-line through the Health Connector at MAhealthconnector.org or by calling 877-MA-ENROLL. You can also apply to buy insurance directly through an insurance company or insurance agent.

What if I qualify for subsidized coverage?

You may qualify for subsidized health insurance through the Health Connector or MassHealth. If you qualify, different enrollment rules apply and you might be able to enroll without a waiver.  For example, a family of four with income of $95,400 per year or less (about $7,950 per month or less) may qualify for a subsidy. Go to MAhealthconnector.org for more information.

Do I need an enrollment waiver?

You may not need an enrollment waiver if:

  • You lost insurance coverage recently (usually within the past 63 days); or
  • You are a small business owner buying insurance for your business; or
  • other reasons may apply

Who cannot get an enrollment waiver?

You cannot get an enrollment waiver if you have or had health insurance coverage that you voluntarily terminated through not paying premiums or other actions, and have had no insurance for more than 63 days. You may be able to buy insurance during the next open enrollment period.

Where can I get a waiver of the tax penalty for going without insurance?

The Office of Patient Protection cannot issue waivers of state or federal tax penalties.  Those waivers are handled by different government agencies.  If you are looking for a waiver of the tax penalty for being uninsured, contact:

  • For state taxes, contact the Health Connector at 617-933-3164, and ask about the “Certificate of Exemption”
  • For federal taxes, contact the federal Health Insurance Marketplace Call Center at 800-318-2596

Questions?

If you have questions about the enrollment waiver process, please call the Office of Patient Protection at 800-436-7757, or email us at HPC-OPP@state.ma.us. Please do not send personal health information by email.

If you have questions about the law that governs open enrollment and eligibility, please call the Division of Insurance at 617-521-7794 or visit its website at www.mass.gov/doi.

If you have other questions about whether you qualify for health insurance, you can contact the following places for more information:

MassHealth, 800-841-2900

Health Care Division, Office of the Attorney General, 888-830-6277

The Connector, 877-MA-ENROLL

Health Care For All, 800-272-4232

Please also see the Frequently Asked Questions about Open Enrollment and Waivers  

Waiver Form pdf format of    Waiver Form  doc format of Waiver Form  

Last updated March 2014