Special Enrollment Period for Affordable Care Act opens Feb. 15


Brittney Lofthouse – Contributing Writer

In most states, open enrollment for 2021 health plans ended on Dec. 15, 2020. HealthCare.gov, which is the exchange platform that’s used by the majority of the states, tends to follow this schedule, while the states that run their own exchange platforms generally offer slightly longer enrollment windows.

The Biden administration has announced a COVID-related special enrollment period on HealthCare.gov. It will run from Feb. 15, through May 15, 2021, and will be available for anyone who is eligible to use the marketplace, including people who are currently uninsured as well as those who already have coverage through HealthCare.gov and would prefer to pick a different plan.

“The department is committed to ensuring that we deploy every available resource during the Public Health Emergency. This Special Enrollment Period will ensure that more individuals and families have access to quality, affordable health coverage during this unprecedented time,” said HHS acting secretary Norris Cochran.

Since the implementation of the Affordable Care Act, more than 20 million Americans have been enrolled in insurance plans, many of whom qualify for a tax credit that makes insurance more affordable. Open enrollment is a time to make changes to a health insurance plan or to buy a different one. 

The Special Enrollment Period will be offered to consumers applying for new coverage or updating an existing application through HealthCare.gov, the Marketplace call center, or through direct enrollment channels. Coverage is prospective, with coverage beginning the first day of the month following the date of plan selection and the first payment if applicable.

HealthCare.gov is used in 36 states for enrollment in 2021 health plans, and the special enrollment period will be available in all of them.

Macon County Blue Cross and Blue Shield Agent Kevin Corbin, said that his office is prepared to help the community navigate the newly announced Special Enrollment Period and will answer questions free of charge. 

Corbin said if you are happy with your current policy and insurance plan, then you can keep it as long as it is still being offered. According to Corbin, a lot of people may find themselves turning to the ACA Marketplace for the first time as an estimated 260,000 North Carolinians are without insurance due to a loss of employment associated with COVID19. 

“With unexpected unemployment occurring because of COVID19, hundreds of thousands of people in our state no longer have insurance,” said Corbin. “If those individuals did not enroll through the Marketplace during the Special Enrollment Period, or the days after losing their jobs, then Open Enrollment will be the first time they will have a chance to shop insurance plans through the ACA.”

Individuals can buy an individual health plan through the ACA marketplace or directly from an insurance provider. 

Qualifying depends on your family size and income and your family income must fall between 100% and 400% of the federal poverty level (FPL). Based on this formula, for 2021 coverage for a family of four, the income bracket between 100% and 400% is $26,200 to $104,800.

While individuals can shop insurance plans through the Marketplace online, Corbin recommends visiting an insurance agent, who will help them navigate the process. 

“We help people sign up for insurance and understand their options, and it does not cost anything fo your services,” said Corbin. “If you are sick, you go to a licensed medical professional, so when you need insurance, you should go to a licensed insurance agent. We have a program that makes it easy to see and understand all of your options and it does not cost anything for you to make an appointment and sit down with us.”

Corbin said the Special Enrollment Period may not mean any changes at all for Americans who are currently insured. 

“If you are happy with your coverage, then you don’t have to do anything at all,” said Corbin. “As long as that plan is still being offered, which most of them are, you don’t have to do anything and you will continue with the same coverage you have had.”

Outside of open enrollment, plan changes and new enrollments are normally only possible for people who experience a qualifying event, but the COVID-related special enrollment periods in most of the country are providing significant flexibility on this for 2021 coverage.

After open enrollment ends, people can normally only purchase coverage if they have a special enrollment period triggered by a qualifying event such as:

• Marriage (since 2017, this generally only applies if at least one spouse already had coverage before the wedding, although there are some exceptions),

• Becoming a U.S. citizen,

• Birth or adoption,

• Involuntary loss of other health coverage.

• A permanent move to an area where new health plans are available (since July 2016, this only applies in most cases if you already had coverage prior to your move).

For more information about open enrollment and the Affordable Care Act, visit healthcare.gov.