New ACA SEP opened through 2022, 150 FPL or below

[jim584672]

A new Special Enrollment Period (SEP) for advance payments of the premium tax credit (APTC) eligible consumers with a household income at or below 150% of the Federal Poverty Level (FPL).

https://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/150FPLSEPTATIPSHEET

Since the public health emergency (PHE) will be ending soon, millions will be thrown off Medicaid. Looks like they are throwing out a lifeline for them. People on Medicaid have been locked in since March 2020 due to the PHE.

 

[SecondCor521]

Interesting, thanks.

I would have thought that the loss of Medicaid would make one eligible for an SEP on an individual basis. I guess this is so that one doesn't have to provide documentation to prove loss of coverage?

 

[jim584672]

Interesting, thanks.

I would have thought that the loss of Medicaid would make one eligible for an SEP on an individual basis. I guess this is so that one doesn't have to provide documentation to prove loss of coverage?

That is what I am thinking.

The Silver plans @ <150% are $0 premium in 2022 due to American Rescue Plan law.

 

[jim584672]

Not so in NE Fla. DW qualifies and pays nearly $200 a month for a Silver Florida Blue Plan.

150% FPL and under is 0% for the SLCSP in 2022. See the page 183 table in https://www.congress.gov/117/plaws/publ2/PLAW-117publ2.pdf.

 

[jim584672]

As mentioned, not so in Florida as they have not expanded Medicaid. The subsidy for anyone under $17,239 is $0. Check the
Calculators. Use Zip Code 32092 and enter $17,239 as income and 2 people in household.

https://www.healthinsurance.org/obamacare/subsidy-calculator/

In FL the ACA has a gap between 0% and 100%, no subsidy and no Medicaid. 100% to 150% would qualify for a $0 Silver SLCSP in 2022. 0% to 100% is full price.

 

[GTFan]

Tell that to our insurance broker, healthcare.gov and Florida Blue. We went through this with them many times. anything Below $17,240 gets a Zero Subsidy.

Yes, but that's not what's he's saying. If your income is between 100% and 150% you WILL get a subsidy that makes your SLSCP $0 cost.

You're talking about income below 100% which he agreed would be no subsidy (like all non-expanded Medicaid states), and your plan is not the SLSCP.

 

[jim584672]

In FL the ACA has a gap between 0% and 100%, no subsidy and no Medicaid. 100% to 150% would qualify for a $0 Silver SLCSP in 2022. 0% to 100% is full price.[/QUOTE

Tell that to our insurance broker, healthcare.gov and Florida Blue. We went through this with them many times. anything Below $17,240 gets a Zero Subsidy.

I hope you bought the policy through healthcare.gov so you can get subsidies. It can be reconciled at tax time. Income between 100% and 400% (more in 2022) will get subsidies.

 

[jim584672]

The FPL is between the subsidy range by law you get them. I don't care what I see in a screen shot since I don't know what inputs made the screen or if healthcare.gov has an error in some way.