The coronavirus disease 2019 (COVID-19) national emergency has presented unprecedented challenges for the American public. Many Americans face uncertainty and are experiencing new health problems during the pandemic. Thanks to the exceptional circumstances and rapidly changing Public Health Emergency (PHE) impacting numerous people throughout the US a day, many Americans remain uninsured or underinsured and still need affordable health coverage.
In accordance with the chief Order issued by President Biden, the Centers for Medicare & Medicaid Services (CMS) determined that the COVID-19 emergency presents exceptional circumstances for consumers in accessing insurance and has provided a Special Enrollment Period (SEP) for people and families to use and enroll. This SEP is going to be available to consumers within the 36 states served by Marketplaces that use the HealthCare.gov platform, and CMS will conduct outreach activities to encourage those that are eligible to enroll in health coverage. CMS strongly encourages states operating their own Marketplace platforms to form an identical enrollment opportunity available to consumers in their states.
Having started on February 15, 2021, and continuing through May 15, 2021, Marketplaces using the HealthCare.gov platform will operationalize functionality to form a SEP available to all or any Marketplace-eligible consumers who are submitting a replacement application or updating an existing application. These consumers will have options to access the SEP through a spread 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, alongside over 8,000 trained assisters, able to assist consumers with their application for coverage.
To promote the SEP and make sure that a broad and diverse range of consumers are conscious 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 mixture of paid advertising and direct outreach to consumers. Outreach efforts will include considerable awareness-building efforts to encourage the uninsured and people who come to HealthCare.gov to explore coverage to continue the method and enroll. CMS plans to spend $50 million on outreach and education, on a mixture of tactics to extend awareness, including advertisements on broadcast, and digital media.
Some consumers may already be eligible for other existing SEPs, Medicaid, or the Children’s insurance Program (CHIP) – they should visit HealthCare.gov now for information.
Starting February 15, consumers seeking to take advantage of this SEP can determine if they are eligible by visiting HealthCare.gov and are not any longer limited to calling the Marketplace call center to access this SEP. Consumers who are eligible and enroll under this SEP should be ready to select coverage that starts after the month of plan selection. Consumers will have 30 days after they submit their application to settle on a choice. Current enrollees should be ready to change to any available plan in their area without restriction to an equivalent level of coverage as their current plan. To use this SEP, current enrollees should step through their application and make any changes if needed to their current information and submit their application to receive an updated eligibility result before continuing to enrollment. This SEP opportunity will not involve any new application questions or require consumers or enrollment partners to supply any new information not otherwise required for eligibility and enroll in coverage. Additionally, consumers will not need to provide any documentation of a qualifying event (e.g., loss of employment or birth of a child), which is usually required for SEP eligibility.