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Finding coverage that works for you: Q&A about the ACA Marketplace’s extended special enrollment period

Key Takeaways

  • People can purchase individual coverage on the federal Marketplace at through Aug. 15, 2021.
  • More people may be eligible for help with coverage costs.

We recently sat with Misty McDougal, product manager on the BlueCross product strategy and individual market team, to talk through some of the developments impacting people who are purchasing health insurance coverage on their own through the Affordable Care Act (ACA) Marketplace, maybe for the first time. The ACA Marketplace, also known as the federal exchange, is an online market where individual consumers can compare health insurance plans based on costs, benefits, and other important features; choose a plan; and enroll in coverage.

Read on to learn what you might need to know about the opportunities available during the extended special enrollment period (SEP)  that’s running through mid-August. 

Open enrollment for Marketplace plans is usually limited to the fall. What’s changed, and when can people sign up?

In light of the ongoing COVID-19 public health emergency, the federal government opened and extended an SEP to give people another opportunity to sign up for health insurance through the federal Marketplace. This SEP started Feb. 15, and consumers can search plans, change their existing plan, and sign up for coverage on through Aug. 15, 2021.

While the ACA has always offered help with premium costs, the latest COVID-19 relief bill changed how the tax credits, or subsidies, work. What do our BlueCross members or potential members need to know?

The American Rescue Plan Act, which passed in March, will help lower premiums (that’s the amount people pay each month for insurance coverage) for just about everyone seeking an individual health insurance plan – including those who previously made too much money to qualify for help.

Under the new bill, premiums are capped at a lower rate. No one will pay more than 8.5% of their household income toward the cost of a plan. The bill also increased premium tax credits, which reduces the amount an individual or family pays for their Marketplace health insurance coverage.

Increased tax credits mean many consumers will have the chance to switch to a plan with more benefits for the same cost.  The ACA has four categories of plans – bronze, silver, gold, and platinum – and someone who previously had a bronze-level plan could move to silver level coverage for around the same price. As of now, these expanded tax credits will extend into 2022.  

There’s also a significant benefit for those who have lost their jobs: people who have received or been eligible for unemployment insurance benefits this year will automatically be eligible for a 2021 Marketplace insurance plan with no premium. If they decide to buy a plan with more coverage, they are also eligible for premium tax credits that would lower their deductible and other out-of-pocket expenses.

Tennesseans in most regions have several options for individual health coverage. What makes our plans stand out?

The provider networks we’ve built across the state are what set us apart. BlueCross plans offer access to doctors and hospitals who are committed to quality care, as well as wellness incentives and online tools that help members find the provider to best meet unique health needs.

Middle and West Tennessee residents can also benefit from our partnership with Sanitas Medical Centers. These facilities only serve BlueCross members and self-pay patients and offer in-network primary care, urgent care and more in the Memphis or Nashville areas.

For those who want the option of virtual care, our plans cover telehealth visits with any of our in-network providers – including PCP and specialist visits, behavioral health services and more.

As people review options during this SEP, it’s important for our current members to know that “staying Blue” has its advantages – especially if you’ve already used your health plan this year. When you move from one of our plans to another during this time, any amount you’ve already paid toward your out-of-pocket or deductible limits is applied to your new plan. If you go with a non-Blue option, those limits reset to $0, which could end up costing you more.

About Alison Sexter, Communications Specialist

A photo of the authorAlison has been a member of the BlueCross BlueShield of Tennessee corporate communications team since 2015. A Chattanooga native, she has a decade of health care communications experience including writing, editing, public relations and social media.

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