The Affordable Care Act (ACA) Health Insurance Marketplace is opening back up for a new Special Enrollment Period. CMS recently announced the decision, which was made in response to the ongoing COVID-19 pandemic.
When Will Enrollment Open?
The ACA Marketplace is currently set to open on February 15, 2021 and will stay open through May 15, 2021. This is an ongoing situation, so changes and extensions may be possible, but they should not be assumed at this point.
Who Qualifies for the Special Enrollment Period
The Special Enrollment Period applies to the 36 states that use HealthCare.gov for their ACA Health Insurance Marketplace. In these states, individual and families will be allowed to apply and enroll in coverage.
Other states that use their own state platform instead of HealthCare.gov may also create a new Special Enrollment Period, and CMS is encouraging these states to do so. Consumers in these states should check their state exchange for more information.
How Can Consumers Take Advantage of the Special Enrollment Period?
During the Special Enrollment Period, all Marketplace-eligible consumers will be able to submit a new application or update an existing application. Consumers can do this through the HealthCare.gov website. They can also use the Marketplace call center or direct enrollment channels, or they can get assistance from Marketplace-registered agents or trained assisters.
According to CMS, the following rules apply to this Special Enrollment Period:
- Consumers who are currently enrolled can change to any available plan at the same level of coverage.
- Consumers will have 30 days after submitting an application to choose a plan.
- Coverage should start the first of the month after plan selection.
Do People Need to Wait for the Special Enrollment Period?
This Special Enrollment Period applies to all Marketplace-eligible consumers. However, some individuals and families may qualify for other Special Enrollment Periods based on their specific circumstances.
For example, people may use the HealthCare.gov site to see if they qualify for Medicaid and CHIP at any time. Additionally, when someone loses job-based coverage, moves, gets married or divorced, has a baby or experiences other major household changes, they may qualify for a Special Enrollment Period.
Does the Special Enrollment Period Apply to Medicare?
This new Special Enrollment Period only applies to the ACA Marketplace at HealthCare.gov. It does not apply to Medicare Advantage enrollment.
It is possible that more announcements will be made regarding this, and we are monitoring the situation closely. In the meantime, it should be noted that both the Medicare General Enrollment Period and the Medicare Advantage Open Enrollment Period run from January 1 to March 31.