Low-income families can now apply for health insurance at any time of the year through the federal Marketplace.
A change in the Affordable Care Act offers special enrollment for those households that fall below 150% of the federal poverty level.
“This is to reach more of the underserved and under-insured, low-income families to give them an opportunity to have health insurance without being limited to a certain timeframe,” Rhonda Culp, director of care coordination for Thrive Allen County, said.
The federal health insurance Marketplace is part of the Affordable Care Act, that offers health insurance to those who don’t have coverage through their employer. Subsidies, typically based on income, lower the monthly premium cost.
For most, the health insurance exchange offers open enrollment in November and December, but this year it was extended to Jan. 15.
Special enrollment is available to those who have a major life change, such as getting married, changing jobs, having a baby or other situations.
Opening enrollment at any time for those with lower incomes will give them more options, Culp said.
Sometimes, a person enrolls in a health insurance plan but finds their health provider doesn’t accept that particular plan. They must look for a different provider who takes their insurance, and may have to travel to do so. That can be difficult for those with lower incomes.
Now, if a plan doesn’t meet their needs, someone with a lower income can switch at any time. Changing insurances will also reset any deductible or out-of-pocket limits to $0, Culp warned, but a different plan might be a better fit.
THE EXTENDED enrollment doesn’t address the Medicaid coverage gap, though.
Kansas is one of a dozen states that has not expanded Medicaid, which limits insurance options for people who are working but don’t make much money.
Federal health insurance subsidies are only available to those who make more than 100% of the federal poverty limit. In states that haven’t expanded Medicaid, those families typically don’t qualify for affordable health insurance.
“Unfortunately, that hasn’t changed,” Culp said.
TO QUALIFY for the special enrollment, annual incomes must be less than the following:
For a single person, $17,774.
For a family of two, $26,130.
For a family of three, $30,305.
For a family of four, $36,570.
For a family of five, $42,835.
Thrive has a system of health insurance Navigators who can help people enroll.
Culp encourages anyone who is interested to call Thrive for more information, even if they live outside Allen County. Thrive staff can direct them to a Navigator in their area.
