UnderstandingOpenEnrollmentDuringCovid-1
ACA Marketplace coverage & Coronavirus

Need health insurance?

New, lower costs on Marketplace coverage available now.

More people than ever before will qualify for help paying for health coverage, even those who weren’t eligible in the past.

There’s a new Special Enrollment Period for the COVID-19 public health emergency. You can enroll in or change Marketplace health insurance plans through August 15, 2021.

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If you already have coverage through the Marketplace, the rules in your Marketplace health plan for treatment for the coronavirus disease 2019 (COVID-19) emergency remain the same as any other viral infection, but your health insurance company may have added benefits.

  • See what Marketplace plans cover. All Marketplace plans cover treatment for pre-existing medical conditions and can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.

  • Check with your health insurance company for their specific benefits and coverage policy.

  • Log in to update your Marketplace application if COVID-19 impacts your income or household. You may be able to change your plan if certain situations apply.

If I lost my job or experienced a reduction in hours

If you lost your job-based health plan: There’s a new Special Enrollment Period for the COVID-19 public health emergency. You can enroll in or change Marketplace health insurance plans through August 15, 2021.

After August 15, you may qualify for a Special Enrollment Period if you lost health coverage through your employer or the employer of a family member in the past 60 days OR you expect to lose coverage in the next 60 days, including if you lose health coverage through a parent or guardian because you're no longer a dependent. In addition, you may qualify for a Special Enrollment Period if you lost health coverage through your employer more than 60 days ago but since January 1, 2020 and were prevented from enrolling in health coverage due to the national emergency on COVID-19. Note: Since FEMA declared an emergency due to COVID-19, if you lost coverage more than 60 days ago, you only qualify for a Special Enrollment Period if you missed the deadline to enroll due to being impacted by the national emergency on COVID-19. Voluntarily dropping coverage doesn't qualify you for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan.

  • If your employer reduced the hours you work and you’re enrolled in a Marketplace plan: Update your application immediately within 30 days to report any household income changes. You may qualify for more savings than you’re getting now. Learn how to report changes.

  • If you were furloughed: In some situations depending on the status of your health coverage from your employer, you may qualify for a Special Enrollment Period. You may be eligible for a premium tax credit to help pay for Marketplace coverage too. Create an account to start your Marketplace application to find out if you qualify.

  • Need help estimating your income? Use this income calculator to make your best estimate.

  • If you have COBRA continuation coverage:

    • If you’re entitled to COBRA continuation coverage after you lost your job-based coverage, you may still qualify for a Special Enrollment Period due to loss of coverage. You have 60 days after your loss of pre-COBRA job-based coverage to enroll in Marketplace coverage. You may also qualify for premium tax credits if you end your COBRA continuation coverage, or if you didn’t accept it to begin with.

    • If you're enrolled in COBRA continuation coverage, you may qualify for a Special Enrollment Period if your COBRA continuation coverage costs change because your former employer stopped contributing, so you have to pay full cost. Learn more about COBRA continuation coverage and the Marketplace.

  • If you lost your job, but didn’t also lose health coverage, because your former job didn’t offer coverage: You generally won't qualify for a Special Enrollment Period. By itself, a job loss (or a change in income) doesn't make you eligible for a Special Enrollment Period to enroll in Marketplace coverage.

If I can’t pay my premiums because of a hardship due to COVID-19
  • Check with your insurance company about extending your premium payment deadline or ask if they will delay terminating your coverage if you can’t pay your premiums.

  • Most of the time, if you aren’t receiving financial assistance with your premiums, you have a grace period determined by state law (often one month). If you’re getting financial assistance, you have a three-month grace period during which your coverage can’t be terminated for not paying your premiums.

  • If your household income has changed, update your application immediately. You could qualify for more savings than you're getting now.

If I’m enrolled in a Marketplace plan and my income has changed

If you’re enrolled in a Marketplace plan and your household income has changed, update your application immediately. If your income goes down or you gain a household member:

  • You could qualify for more savings than you’re getting now. This could lower what you pay in monthly premiums.

  • You could qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

  • Need help estimating your new income? Use our income calculator to make your best estimate.

If I get a direct deposit or check from the IRS that is called an economic impact payment

The American Rescue Plan Act calls for the IRS to make a third round of economic impact payments of up to $1,400 per taxpayer and $1,400 for each qualifying child.

You may also have received earlier economic impact payments:

  • The COVID-related Tax Relief Act of 2020, which called for the IRS to make a second round of economic impact payments of up to $600 per taxpayer and $600 for each qualifying child.

  • The Coronavirus Aid, Relief, and Economic Security (CARES) Act, which called for the IRS to make economic impact payments of up to $1,200 per taxpayer and $500 for each qualifying child.

If you get one of these payments, you don't need to include it in the income you report on your HealthCare.gov application. These payments don't impact your eligibility for financial assistance for health care coverage through the Marketplace, or your eligibility for Medicaid or the Children’s Health Insurance Program (CHIP). For more information, visit IRS Coronavirus Tax Relief information.

If I have limited Medicaid that covers COVID-19 diagnostic testing only

In some states, Medicaid may cover COVID-19 testing if you don’t have other health coverage and don’t qualify for full Medicaid or CHIP coverage. This limited Medicaid benefit only covers COVID testing and doesn’t cover any other health care benefits and services. It doesn’t count as having qualifying health coverage.

  • With limited coverage, you can fill out a Marketplace application to find out if you qualify for comprehensive coverage, including COVID-19 testing, through either Medicaid or the Marketplace with savings based on your income. When you apply, don’t tell us that you have Medicaid.

  • If you enroll in Marketplace coverage and qualify for help paying for that coverage, notify your State Medicaid agency of this new coverage.

  • Note: If your COVID-19 testing Medicaid coverage ended, you may still be eligible to enroll in a Marketplace health plan through August 15 due to the COVID-19 emergency. Learn more about Special Enrollment Periods.

Learn more about Medicaid coverage and the Marketplace.

How Wah Financial Services can help

Navigating the intricacies of ACA-compliant health insurance can be difficult for just about anyone, nevermind those going through COVID-related or other kinds of tragedies.

This is where the Wah Financial Services comes in.

If you contact us, we can get started right away on helping you to make every decision you need to make regarding the options available in 2021 for your state. This could include looking at Guaranteed Issue plans, for example.

You can discuss ACA Marketplace Plans, Fixed Benefit, Short Term, and whatever other options you want with us and we will help you in deciding what might be the best for you based on the specifics of you, your family, and your situation.

Everyone has a different situation based on their employment, age, health, family, and potentially many other factors.

Wah Financial Services has been in service for over 7 years licensed in multiple states and contracted with major Carriers 

We’re excited to talk to you about what is possible for securing you and your family’s future in terms of surviving in the time of COVID-19.

That’s why it’s important that you go ahead and contact us today as fast as you are able. Events move extremely quickly during the pandemic, and the longer you wait, the more your situation might change in terms of health and employment.

Sincerely,

Cindy Wah 

Source: Healthcare.gov