People who are eligible to use the ACA Marketplace for health insurance will have another shot at getting the right coverage.
A recent fact sheet from CMS says that “Millions of Americans are facing uncertainty and millions of Americans are experiencing new health problems during the pandemic.” To help with the ongoing crisis, and in response to a recent executive order, a new ACA Special Enrollment Period is being scheduled.
Mark Your Calendars
The ACA Special Enrollment Period started on February 15, 2021, and it will end on May 15, 2021.
The normal Open Enrollment Period for the ACA Marketplace begins on November 1 and lasts through December 15, although some states that use their own marketplace might have slightly different dates.
Outside of the Open Enrollment Period, people can use the Marketplace to see if they qualify for Medicaid and CHIP. Some people may also qualify for Special Enrollment Periods based on household changes, such as losing job-based coverage or moving to a new location.
This year, the new Special Enrollment Period gives people three extra months to make changes to their health plan enrollment.
Do You Qualify for the Special Enrollment Period?
The Special Enrollment Period is available to all Marketplace-eligible consumers. During this time, people can use the Healthcare.gov Marketplace to submit a new application or to update a current application.
However, not all states use the HealthCare.gov Marketplace. Currently, only 36 states use the federal Marketplace. Other states have set up their own Marketplaces. CMS is encouraging these states to establish their own Special Enrollment Periods, but whether or not this actually happens may be up to the individual states.
Also, the ACA Marketplace Special Enrollment Period does not apply to coverage purchased outside the Marketplace. This means it does not include Medicare Advantage.
Special Enrollment Period Details
During the Special Enrollment Period, Marketplace-eligible consumers and submit a new application to enroll in a health plan. Additionally, current enrollees can use the special Enrollment Period to change to any available plan in their area with the same level of coverage as their current plan.
After submitting the application, consumers will have 30 days to select a plan. Coverage will start prospectively on the first on the month after plan selection.
With many Special Enrollment Periods, consumers may have to submit evidence that they qualify. For example, if a consumer claims a Special Enrollment Period based on a move, he or she might need to submit documentation of the move. However, no such documentation will be needed to qualify for this Special Enrollment Period.