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Special Enrollment Option for Marketplace Health Insurance During COVID-19

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If you were eligible for a Special Enrollment Period (SEP) at some point this year but didn’t enroll, you may still qualify for coverage. The FEMA SEP gives you extra time to enroll as all states are covered under the COVID-19 pandemic national emergency declaration. 

South Carolinians who did not enroll this year due to a qualifying event such as loss of coverage, birth of a child, or a change of permanent residence may enroll in coverage, often with financial assistance that reduces monthly costs. “We can help people look at their life events to see if they are eligible. Some of the SEPs must be granted through the Marketplace call center. We can help with that process,” says Shelli Quenga, Palmetto Project’s Director of Programs.

The Marketplace usually has a 60 day SEP window following the loss of coverage, however the application now asks whether the applicant has lost coverage since January 1. “The Marketplace often requires that applicants submit proof of the loss of coverage. We can help people upload such documents directly into their online account,” says Quenga, “We are here year-round to help people with any health insurance questions and concerns, from getting their member ID cards to understanding medical bills and provider networks.”

Coverage begins the first day of the month following plan selection. However, a consumer can contact the Marketplace call center to request a retroactive effective date. “This could be especially helpful for consumers who have sought costly medical treatment, but had lost job-based coverage,” added Quenga.

Marketplace plans are required to cover essential health benefits such as prescription drugs, lab services, and hospitalization. This comprehensive coverage is guaranteed with no pre-existing condition exclusions or markups. Testing and treatment of COVID-19 are covered by all ACA plans, and testing is covered with no cost sharing.

The health insurance landscape can be confusing. Local in-person help is available at no cost. Call Palmetto Project to talk with an expert who can help you navigate the enrollment process by visiting www.Insure-SC.org or calling 1-888-998-4646 or 843-577-4122.

1 Comment

1 Comment

  1. Steve

    August 22, 2020 at 3:05 pm

    Thank you, HCS for helping get the word out on this. If anyone lacks health coverage or is unsure about his or her current coverage (including Medicare, Medicaid, and ACA), call us at 888-998-4646. Great help at no cost.

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