CLICK THE VIDEO ABOVE THATS SHOWS HOW THE ACA MARKETPLACE WORKS
In today's world, access to affordable healthcare is more crucial than ever. The Affordable Care Act (ACA) Marketplace provides a unique opportunity for individuals and families facing financial challenges to access comprehensive healthcare. Many are unaware that there is a "Special Enrollment Period available every day of the year for households earning 150% or less of the federal poverty level. This blog post will clarify what this means, how it works, and why it’s vital to seize this opportunity.
Understanding the ACA Marketplace
The ACA Marketplace, or Health Insurance Marketplace, was created to help people find health insurance that meets their needs at a price they can afford. Each year, there is a designated Open Enrollment Period during which anyone can sign up for health coverage. "ACA Annual Open Enrollment" usually runs form November 1st until January 15th. However, outside of this period, people typically must experience a qualifying event, such as a change in income or family status, to enroll.
What is a Special Enrollment Period (SEP)?
For households making 150% or less of the federal poverty level, the ACA offers a special year-round enrollment period. This flexibility means you can enroll in health coverage whenever you need it, which is essential for families facing unexpected health issues or sudden changes in financial conditions.
For the 2025 coverage year, the thresholds for 150% of the federal poverty level are as follows:
150% of the Federal Poverty Level for 2025
Household Size | 150% FPL Income Limit (2025) |
1 | $22,230 |
2 | $30,000 |
3 | $37,770 |
4 | $45,540 |
5 | $53,310 |
6 | $61,080 |
7 | $68,850 |
8 | $76,620 |
For households with more than 8 members, add approximately $7,770 for each additional person. If you household income is at or underneath income amounts shown you would probably qualify for health insurance through the ACA marketplace. By understanding these income limits, individuals can more easily determine eligibility for the Year-Round Special Enrollment Period that can unlock comprehensive healthcare!
Why It Matters
A significant number of people do not know this option is available, which can lead to missed chances for vital healthcare coverage. In fact, studies show that uninsured individuals are more likely to forgo necessary medical care due to costs. According to a 2022 report from the Kaiser Family Foundation, nearly 29 million Americans were without health insurance.
Being uninsured can lead to severe consequences, including high medical bills and increased stress for families trying to make ends meet. Access to health insurance provides security, allowing individuals to seek prompt medical care without worrying about unmanageable expenses. Preventive care, which is often covered fully by insurance, can save lives and reduce long-term healthcare costs.
How to Utilize the Year-Round Special Enrollment Period
If you think your household income qualifies for the special enrollment period, follow these steps:
Check Your Eligibility: Determine your household size and income against the 150% federal poverty level requirement. You can reference the latest poverty guidelines on the official Health and Human Services website.
Visit the ACA Marketplace: Our agency is a local ACA Health Insurance agency located in Upstate SC. We have access to the ACA Marketplace and can help to see if you do qualify and if you do qualify help you enroll in ACA health coverage. Our services are "Free" when helping answer any questions you may have about the ACA Marketplace and, helping you enroll in a plan.
Compare Plans: Our office can help you compare plans and help you choose which plan option is best for you and your family. You can review costs, networks, and coverage to help you select the most suitable plan for your needs.
Enroll: Choose the plan that fits your need and budget. We can help you enroll in coverage in less than 20 minutes.
Stay Informed: After enrolling, monitor any changes in your health status or income, as they might affect your coverage or eligibility.
Key Terms to Know
Familiarizing yourself with essential terminology related to the ACA can help you navigate the insurance landscape more effectively. Here are a few important terms:
Marketplace: An online platform to purchase health insurance.
Premium: The monthly payment you make for your health insurance.
Deductible: The amount you pay for healthcare services before your insurance covers the costs.
Subsidies: Financial assistance that lowers the cost of your health insurance premiums.
Frequently Asked Questions
1. Can I apply for the Special Enrollment Period at any time?
Yes! If your household income is at or below 150% of the federal poverty level, you can apply year-round. There are also other events that could help you qualify for a separate Special Enrollment Period.
2. What if my income fluctuates throughout the year?
You can update your application anytime your income changes, affecting your eligibility for different plans or subsidies.
3. Can I receive help when filling out my application?
Yes! Contact our office and we can help you choose the right plan and assist with enrolling you. Our services are "Free" when helping you enroll in a marketplace plan.
Taking Charge of Your Health
The Year-Round Special Enrollment Period in the ACA Marketplace is a valuable opportunity that many may overlook. For individuals and families with a household income at or below 150% of the federal poverty level, this period allows you to secure affordable health insurance coverage when you need it most.
By understanding your eligibility and the steps to enroll, you can access vital resources and care that significantly improve your quality of life. Still don't have health insurance? Don't wait until a health crisis occurs; take proactive steps for your health and explore your options in the ACA Marketplace. Good health is not just about surviving; it’s about thriving. Contact our office today for more information about this Special Enrollment Period.
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