If you have already purchased an insurance plan through the Marketplace in 2019, your health plan for treating coronavirus remains the same, since COVID-19 is classified as a regular viral infection. This article is an insurance guide all about applying for healthcare during special enrollment.
It is highly recommended to do the following things:
Check what is exactly covered by Marketplace plans on HealthCare.gov. They usually cover outpatient care outside of hospital, hospitalization, emergency services, prescription drugs, laboratory services, pediatric services, and others. Contact your insurance company to find out what coverage policy and specific benefits they offer.
All Marketplace plans provide coverage of treatment for any pre-existing medical condition. The coverage cannot be terminated due to health status changes, including treating coronavirus. Since your coverage remains the same, you have an option to update your Marketplace if COVID-19 has an impact either on your household or income. You can also change your current insurance plan under certain circumstances.
The following will explain special circumstances that allow applying for healthcare during special enrollment due to COVID-19.
1. Losing a job or having fewer work hours caused by COVID-19
If you do not have your employer-sponsored insurance anymore. If you have had an employer-sponsored plan one of your family member’s employers and you have lost it, you may be able to apply for a Special Enrollment Period within 60 days.
If you know you are going to lose your coverage in the next 60 days, including the situation when you lose your coverage through your guard or parents because you are not considered dependent anymore, you might be also eligible for a Special Enrollment Period.
However, it is important to know that it is not an option for you if you have dropped the coverage voluntarily. You are also not qualified if the coverage was lost due to the non-payment of your premium.If you are experiencing the reduction of work hours. You should update your application on HealthCare.gov and inform about the changes in your household within 30 days. This may affect your coverage or savings you are eligible for. When updating your application, you may be asked to submit the documents verifying your income like your citizenship, income, or immigration status.
You can submit your documents either online or by mail. The documents sent by fax or email are not accepted. All documents must be original.
2. If you have experienced furlough
A Special Enrollment Period might be an option for you, depending on your employer-sponsored plan. There is a premium tax credit option that can be used to pay for your Marketplace coverage. You find out whether you are eligible or not if you log into your account on HealthCare.gov.
3. If your COBRA continuation coverage is still active
If your COBRA coverage is not canceled yet after your loss of employer-sponsored insurance, you may be qualified for a Special Enrollment Period. After your pre-COBRA job-based coverage was canceled, you will have a 60-days window. If your former employer is not contributing anymore, which caused changed in your COBRA coverage, and you are responsible for full cost, you may be eligible for a Special Enrollment Period.
4. If you were laid off but did not have any employer-sponsored coverage
A job loss itself does not make you eligible for a Special Enrollment Period, so Marketplace coverage enrollment will not be an option for you.
What are the dates of a Special Enrollment Period for those who lost their job?
For those who have already lost the coverage, the Marketplace coverage starts the first month after applying and enrolling.If you expect your coverage be canceled within 2 months (60 days) it is recommended to submit your application through HealthCare.gov while the coverage is still active. This will allow you not to have a gap. For example, if you expect to lose your coverage on March 31st and you apply for a Marketplace coverage on March 10, your new plan will be active on April 1.
5. If you are not able to pay your premium due to the financial hardship caused by COVID-19
Talk to your health insurance agent to find out if they agree to extend the deadline. You can also ask if they are going to delay terminating your insurance coverage in case you are not able to make payments.In most cases, if you are not receiving any financial assistance, you are qualified for a grace period.
The duration of the grace period depends on each state law. If you are being provided with financial assistance, the grace period is 3 months. During this period of time, your coverage will not be terminated for non-payment of premiums.If your income has changed, you should update your application as soon as possible because you may be eligible for more savings.
6. If you have Marketplace coverage but your income has changed
If your income has changed due to COVID-19, you should change your application as soon as possible for the following reasons:
You may be qualified for more savings, which will lower you monthly premium paymentsThere might be low-cost or free coverage through such programs CHIP (The Children’s Health Insurance Program) or Medicaid available.
7. If you were eligible for a Special Enrollment Period but did not submit your application on time due to the COVID-19
If you know you were eligible for a Special Enrollment Period but did not apply on time because of the pandemic situation (for example you had coronavirus yourself or were taking care of someone with COVID-19), you may be still able to submit an application for a Special Enrollment Period. You can get more information about your state emergencies on FEMA.gov.
In order to find out whether a Special Enrollment Period is available for you or not, you can contact the Marketplace Contact Center at 1-800-318-2596.
8. If you are thinking of changing your current Marketplace coverage or apply for the first time
In order to make changes in your current Marketplace coverage or enroll for the first time, you have to have a qualifying life event, including having a baby, moving, losing your previous health coverage, getting married, and some others.
Applying for Healthcare During Special Enrollment – Final Thoughts
You may be looking for additional help while applying for healthcare during special enrollment. We recommend you check out some of the government benefit programs available that you may be qualified for. One of the most beneficial government programs during this tough time is the Lifeline program, which helps provide telecommunication services, including free phone service.
One of the largest providers of Lifeline is Q Link Wireless. We provide 3 Gigs of Data, plus UNLIMITED talk & text every month. Applying is easy, requires no credit check, and can be done in minutes. Click here to apply now!