More Opportunities for Consumers to #GetCovered Right Now

By Zachary Baron

Although the first open enrollment period (OE1) ended on March 31, consumers across the nation still might be able to sign up for health insurance and #GetCovered right now. Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) is open year-round, and individuals experiencing “qualifying life events” may be able to get a Special Enrollment Period (SEP) to sign up for marketplace coverage outside of open enrollment.

In fact, earlier this week, the Centers for Medicare and Medicaid Services (CMS) announced two additional situations that may trigger an SEP:

  1. Consumers who:
    • previously applied through the marketplace or their state Medicaid agency,
    • were denied Medicaid because their state chose not to expand coverage, and
    • later experienced an increase in income (so that they now expect to earn at least $11,490 for an individual and $23,550 for a family of four during 2014; at least 100 percent of the federal poverty level).
  1. Consumers who applied for coverage through the marketplace at the end of OE1, had their application transferred to the state Medicaid agency, but were ultimately found ineligible for Medicaid (and so should be eligible for marketplace coverage with financial help, after all).

Consumers must call the marketplace call center at 1-800-318-2596 to see if they can get one of these SEPs. If granted an SEP, consumers will have 60 days to select a plan through the marketplace.

In addition to calling the call center, individuals that have questions about whether they might be able to enroll in coverage now should work with an in-person assister to understand their options.

As Enroll America has highlighted previously, enrollment assisters should continue working with consumers in states that did not expand Medicaid to make sure they do not have to pay a fine for not having coverage when they file their taxes next year. This new announcement from CMS provides additional reasons why assisters and other enrollment partners should continue engaging community members to make sure people are aware of all their affordable coverage options through the marketplace.

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