The new special enrollment period (SEP) effective March 2022 makes it easy for low-income individuals and families to enroll in a marketplace plan outside of open enrollment. To qualify for this SEP, you must be within the 150% federal poverty level and enroll in an on-exchange health plan. Here are qualifications based on household size and income:
You can view the full list of qualifications at healthcare.gov. Qualified applicants can enroll at healthcare.gov or the Friday Health Plans Shopping Portal any time of the year. Coverage starts on the first of the following month.
Q. Who is eligible for this SEP?
A. Here is the breakdown of qualifications: Have an income within the 150% of the federal poverty level AND qualify for a subsidy. You can check both subsidy and income qualifications at healthcare.gov.
Q. Is this SEP available to people in the Medicaid coverage gap?
A. Medicaid-eligible individuals or individuals in the Medicaid Gap cannot qualify for this SEP, as they are not subsidy-eligible. However, lawfully present immigrants who are ineligible for Medicaid due to their immigration status may be eligible for a subsidy and would therefore qualify for this SEP.
Q. How long is the SEP available for?
A. This SEP currently runs through 2022 but may not be permanent.
Q. Is this SEP available in all states Friday Health Plans operates in?
A. This SEP is available on healthcare.gov for Georgia, North Carolina, Oklahoma, and Texas. Colorado residents can enroll in this SEP at connectforhealthco.com. The New Mexico low-income SEP is available for those below the 200% of the federal poverty level (qualifications are different than the ones above).