Public
Healthcare

Revenue Cycle
and Billing

Special Open Enrollment Period Available for Low-Income Individuals, Families

by | Jan 25, 2022 | ACA Enrollment, Affordable Care Act (ACA), Enrollment, Health Equity, Healthcare

Did you know that you can enroll in an Affordable Care Act (ACA) marketplace plan any time during 2022 based on your income or other qualifying events? Thanks to a new special open enrollment period, individuals or families making below 150% of the federal poverty level (FPL) can sign up for a plan throughout the year. 

Who is Eligible for the Low-Income Special Enrollment Period?

You can enroll in an ACA health plan during this year-long low-income special enrollment period (SEP) if you and your dependents are eligible for advance premium tax credits and have a household income under 150% FPL (see the 2022 FPL chart below). If you are a lawfully present immigrant who qualifies for tax credits, you are also eligible to enroll any time in 2022. 

  • For a single person, you can’t make more than $20,385 a year to qualify based on the new poverty guidelines that went into effect on January 12, 2022.
  • For a family of 4, your yearly household income can’t be more than $41,625.
  • The income levels are higher if you live in Alaska or Hawaii. 

Is the Low-Income Special Enrollment Period Available through My State Exchange? 

The low-income SEP is available only through the exchanges. It is not available if you enrolled in a plan off-exchange. 

Some states run their own health exchanges, meaning they do not use the healthcare.gov platform to enroll residents in health plans (see the map below). 

If you live in a state that runs a state-based exchange, you will have to check with your state to see if this low-income SEP is available.

What Type of Plan Can I Enroll In?

You can enroll in any of the metal level plans available in your area. You may be able to get a silver plan at $0 monthly premium. 

I am Already Enrolled in an ACA Plan. Can I Switch Plans?

Yes, but you can switch only to a silver level marketplace plan. If you’re already enrolled in a silver level plan, you can switch to another silver level plan. If you switch plans, any payments you made toward your deductible would not be counted toward your new plan — you would have to meet the full deductible.

Can I Add a New Enrollee?

Yes, but there are rules. You can only add a new dependent or individual:

  • To you current plan
  • To a new silver plan for all of you.

You can also enroll the new enrollee in a separate plan. 

If you want more information on plan types, download Understanding ACA Metal Plans.

When will my Coverage Start?

Your coverage will start the first day of the month after you enroll. For example, if you enroll on February 1, your coverage will start on March 1. 

Are there Other ACA Marketplace Special Enrollment Periods?

Yes. If you don’t qualify for the low-income SEP, you could qualify based on life events, such as having a baby, losing your job, or moving. Check out our Life Changing Event infographic for more information. 

Who Can Help Me Enroll During a Special Enrollment Period?

American Exchange has helped more than 20,000 individuals and families enroll in affordable ACA health plans through the federal marketplace. We can help you enroll during the low-income SEP, when you have life changing events, or during open enrollment. Our licensed brokers help you compare plans, prices, and networks at no cost to you. 

American Exchange is licensed to enroll people through the state exchange if you live in:

  • California
  • Idaho
  • Maryland
  • Nevada
  • New Jersey
  • New York

Get the most affordable plan that best fits your healthcare needs.

Call American Exchange today at 888.995.1674 or email us at  rcm@americanexchange.com