Medicaid Unwinding, A Guide to Getting Marketplace Coverage.

The Families First Coronavirus Response Act created a situation where individuals who were placed on Medicaid stayed enrolled, even if their situation changed such that they would otherwise not newly qualify for Medicaid coverage. This was to ensure people didn’t go without coverage during the national emergency created by the Covid-19 pandemic.

 

Now that the national emergency is over, we have moved into a transition phase. Millions of people across the country, and thousands of people in Utah, are coming off of Medicaid. Many will need other coverage. This period is now known as Medicaid Unwinding. One option for people in this situation is marketplace health insurance.

If you’re navigating the marketplace for the first time, it can feel intimidating or overwhelming. We’re here to help with this guide. If you’d like to have a conversation instead, use the link below.

Generally, when someone has an involuntary loss of coverage, they qualify for what is known as a Special Enrollment Period. This may include loss of coverage due to job change, divorce, or as is happening to many people right now, Medicaid Unwinding. After a loss of coverage, you have 30 or 60 days to submit an application and enroll in a marketplace plan.

 

The length of a Special Enrollment period depends on the Qualifying Life Event. During Medicaid Unwinding, people losing Medicaid will get a 60 day Special Enrollment Period to enroll in a Marketplace plan.

Marketplace insurance plans can be affordable for many individuals and families. There are two  savings programs available through the marketplace for those who qualify; premium tax credits and cost-sharing reductions. To determine if you qualify for subsidies, you’ll need to provide information about your household including how many people are in your household and the total income of everyone in the household.

Start by exploring your options. You can enter just a couple pieces of information and have an idea of what plans are available to you and savings you may qualify for. You can go directly to healthcare.gov or use vendors such as HealthSherpa.

 

Note: You do not need to enter personal information to get estimates. However, for a final determination, you have to complete a Marketplace application.

Check the plans you are interested in to make sure they have your preferred doctors in network. Also checking coverage of prescription medicines you or your family needs is important.

Finally, complete your application, enroll in your chosen plan, and pay your first premium.

Have questions about your unique situation or want help understanding the plans available to you?