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SEP: Important Information About Special Enrollment Period

What You Need To Know About The Special Enrollment Period

If you’re a low-income American and you missed signing up for the 2022 Affordable Care Act, you can now enroll in health care plans through Healthedly Insurance Services. If you have an income less than 150% of the federal poverty level, $19,320 for an individual and $39,750 for a family of four, then you can select policies on healthcare.gov through a special enrollment period.

President Biden and his administration has pushed more funds to programs to help those who are uninsured to enroll and and give assistance to those who lose Medicaid coverage, so that they are able to keep their insurance. This started immediately after taking office where President Biden opened a six-month special enrollment period to allow Americans to sign up for health insurance and take advantage of extra subsidies due to the Covid-19 pandemic.

The extra subsidies brought in 14.5 million Americans to 2022 coverage during the open enrollment. Sign ups were shown to be strong in the states where Medicaid had not expanded to low-income adults, increasing the sign-ups by 21% from the previous year.

Now what are Special Enrollment Periods? 

Special Enrollment Periods or SEP’s are time frames outside of the Open Enrollment Period when a customer can enroll in an Affordable Care Act or Obamacare plan. Open Enrollment is typically between November 1st and December 15th. You can enroll in coverage or even change your plans as long as you qualify for a special enrollment period.

SEP life events include:

Changes in household

  • You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:
  • Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Death. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result you’re no longer eligible for your current health plan.

Changes in residence

  • Household moves that qualify you for a Special Enrollment Period:
  • Moving to a new home in a new ZIP code or county
  • Moving to the U.S. from a foreign country or United States territory
  • If you’re a student, moving to or from the place you attend school
  • If you’re a seasonal worker, moving to or from the place you both live and work
  • Moving to or from a shelter or other transitional housing

Loss of health insurance

  • You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.

With the finalization of the new policies to align with the Biden Administration’s goals to strengthen the ACA and increase enrollment in comprehensive coverage, it further advances their goal by empowering states to develop innovative health coverage to its residents, and lower costs. The effects of these proposals across different groups of state residents also align with the administration’s commitment to ensuring that systemic barriers to opportunities for people of color and other undeserved populations get fair access to affordable healthcare. These policies also further support the overall goal to build on the ACA to meet the needs that were created by the COVID-19 pandemic and the health emergencies that came with it.

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