QUESTION

My marketplace health plan is being discontinued and I didn't go back to the marketplace to select a new plan during open enrollment. But open enrollment is over. What are my options?

Individuals with coverage | Individual and Marketplace Health Coverage
ANSWER

In this situation, you qualify for a special enrollment period since you are losing minimum essential coverage. Under the loss of minimum essential coverage special enrollment period, you have 60 days before and after the last day of coverage to choose another marketplace plan. So if your 2017 coverage ends on December 31, 2017, you can contact the marketplace now to get a special enrollment period. When 2018 coverage becomes effective depends on when you select a plan:

  • if you select a plan on or before December 31, 2017, your 2018 coverage effective date is January 1, 2018;
  • if you select a plan on or before January 31, 2017, your 2018 coverage effective date is February 1, 2018;
  • if you select a plan on or before February 28, 2018, your 2018 coverage effective date is March 1, 2018.

This special enrollment period is also available to you for off marketplace coverage. Note that the marketplace will require that you provide verifying documents of your loss of minimum essential coverage before you can enroll. You will have 30 days to submit the documentation. Also, under marketplace rules for 2018, you will be limited in your plan selection. See this FAQ for more information. (45 C.F.R. § 155.420(d); 82 Fed. Reg. 18346, April 18, 2017; CMS, Overview: Special Enrollment Period Pre-enrollment Verification (SEPV), June 2017).

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