In 2022, consumers will be able to enroll in Marketplace coverage during a new Special Enrollment Period (SEP).
For eligibility, applicants must earn less than 150% of the Federal Poverty Line.
SEPs allow eligible individuals to enroll in Marketplace plans or change their plans through them. If you have previously enrolled in your plan, changes to your plan will reset your premium and deductible maximum.
What Are The Eligibility Requirements For SEP?
In most cases, applicants can apply twice a year:
- Open Enrollment Period typically runs from November 1 to January 15
- Consumers can enroll in Marketplace plans during the Special Enrollment Period, 1/16- 10/31, if they lose employer coverage, become parents, or move.
If you meet either requirement mentioned above, you may be eligible for this Special Enrollment Period:
- A household income below 150% of the federal poverty level
- Get APTCs (Advanced Premium Tax Credits), which are subsidies for your monthly insurance premiums
Does This SEP Not Apply To Everyone?
In order to use this SEP, applicants must qualify to receive APTC (a credit applied to their monthly premium). As a result, Medicaid and insurance provided by their employers are not available to them.
States that operate their own exchanges implement SEP differently than those offered by Federally Facilitated Marketplaces (FFM).
What is the process of determining the effective date?
As part of the monthly SEP, consumers will be able to enroll at any time and begin coverage the following month. Consumers enrolled on 3/30/22 will begin receiving coverage on 4/1/22.
How Can I See If I Qualify For This Grant?
On their eligibility results page, applicants who qualify for this SEP will see that they have received the grant based on their projected household income of 150% of the federal poverty level”.
Is This SEP Going To Last?
At the moment, this SEP is only valid for the calendar year 2022. This subsidy will also need to be extended in conjunction with the American Rescue Plan (ARP). Individuals who qualify for this SEP are able to afford silver plans thanks to ARP subsidies.