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2021 Special Enrollment Period in response to
the COVID-19 Emergency
The coronavirus disease 2019 (COVID-19)
national emergency has presented unprecedented challenges for the American
public. Millions of Americans are facing uncertainty and millions of
Americans are experiencing new health problems during the pandemic. Due
to the exceptional circumstances and rapidly changing Public Health Emergency
(PHE) impacting millions of people throughout the US every day, many Americans
remain uninsured or underinsured and still need affordable health coverage.
In accordance with the Executive Order issued today by President Biden, the
Centers for Medicare & Medicaid Services (CMS) determined that the
COVID-19 emergency presents exceptional circumstances for consumers in
accessing health insurance and will provide a Special Enrollment Period (SEP)
for individuals and families to apply and enroll in the coverage they need.
This SEP will be available to consumers in the 36 states served by
Marketplaces that use the HealthCare.gov platform, and CMS will conduct
outreach activities to encourage those who are eligible to enroll in health
coverage. CMS strongly encourages states operating their own Marketplace
platforms to make a similar enrollment opportunity available to consumers in
their states. Starting on February 15, 2021 and continuing
through May 15, 2021, Marketplaces using the HealthCare.gov platform will
operationalize functionality to make a SEP available to all Marketplace-eligible
consumers who are submitting a new application or updating an existing
application. These consumers will newly be able to access the SEP through a
variety of channels: through HealthCare.gov directly, the Marketplace call
center, or direct enrollment channels. Additionally, consumers can work
with a network of over 50,000 agents and brokers who are registered with the
Marketplace, along with over 8,000 trained assisters, ready to assist
consumers with their application for coverage. To promote the SEP and ensure that a broad
and diverse range of consumers are aware of this implementation, CMS will
conduct an outreach campaign in cooperation with community and stakeholder
organizations, focused on education and awareness of this new opportunity to
enroll in English, Spanish and other languages. CMS outreach efforts
will use a mix of paid advertising and direct outreach to consumers. Outreach
efforts will include considerable awareness building efforts to encourage the
uninsured and those who come to HealthCare.gov to explore coverage to
continue the process and enroll. CMS plans to spend $50 million on outreach
and education, on a mix of tactics to increase awareness, including
advertisements on broadcast, digital, and an earned media. Some consumers may already be eligible for
other existing SEPs, Medicaid, or the Children’s Health Insurance Program
(CHIP) – they can visit HealthCare.gov now to find out if they can
enroll even before this new SEP. Starting February 15, consumers
seeking to take advantage of this SEP can find out if they are eligible by
visiting HealthCare.gov, and are no longer limited to
calling the Marketplace call center to access this SEP. Consumers who
are eligible and enroll under this SEP will be able to select a plan with
coverage that starts prospectively the first of the month after plan
selection. Consumers will have 30 days after they submit their
application to choose a plan. Current enrollees will be able to change
to any available plan in their area without restriction to the same level of
coverage as their current plan. In order to use this SEP, current enrollees
will need to step through their application and make any changes if needed to
their current information and submit their application in order to receive an
updated eligibility result that provides the SEP before continuing on to
enrollment. This SEP opportunity will not involve any new application
questions, or require consumers or enrollment partners to provide any new
information not otherwise required to determine eligibility and enroll in
coverage. In addition, consumers won’t need to provide any documentation of a
qualifying event (e.g., loss of a job or birth of a child), which is
typically required for SEP eligibility. As always, consumers found eligible for
Medicaid or CHIP will be transferred to their state Medicaid and CHIP
agencies for enrollment in those programs. For more information about the Health
Insurance Marketplace®[1],
visit: https://www.healthcare.gov/quick-guide/getting-marketplace-health-insurance/ To view a press release about this
announcement, visit: https://www.hhs.gov/about/news/2021/01/28/hhs-announces-marketplace-special-enrollment-period-for-covid-19-public-health-emergency.html [1] Health Insurance Marketplace® is a
registered service mark of the U.S. Department of Health & Human
Services. |
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Friday, January 29, 2021
2021 Special Enrollment Period in response to the COVID-19 Emergency
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