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There’s a new Health Insurance Marketplace Special Enrollment Period (SEP) available for low-income consumers at or below 150% of the Federal Poverty Level (FPL), which is approximately $19,000 for an individual and $40,000 for a family of four. Consumers who qualify for this SEP may also qualify for more savings. The annual household income at or below 150% FPL varies by state and household size. The 2021 FPL amounts used for 2022 Marketplace applications includes Federal and State poverty levels.
This SEP will be available to consumers who have applied for Marketplace coverage since Open Enrollment ended and who didn’t have access to another SEP from a recent life event, such as a loss of coverage, and will enable eligible consumers to enroll in a Marketplace plan.
Consumers who think they may qualify should visit HealthCare.gov or CuidadoDeSalud.gov to view 2022 plans and prices and enroll in a plan that best meets their needs. This functionality is also available on approved Enhanced Direct Enrollment websites. Additionally, consumers can call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) 24 hours a day, 7 days a week with assistance in over 240 languages.
Consumers residing in states with Marketplaces that operate their own platforms should check with their state Marketplaces regarding whether they are offering this SEP and any actions consumers may need to take.
For more information on this SEP, please view this tipsheet.
In addition, as part of the most recent Marketplace application update, CMS is introducing the newly redesigned Eligibility Determination Notice. The redesign simplifies the notice to better convey information about eligibility and next steps to certain consumers, easing barriers to getting covered and helping consumers access and use their health coverage.
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