After the open enrollment period ends on Sunday for buying coverage on the health insurance marketplaces, people can generally sign up for or switch marketplace plans only if they have certain major life changes, such as losing their on-the-job coverage or getting married. Following insurance industry criticism, last week the people鈥檚 applications for such 鈥渟pecial enrollment periods鈥 more closely, including one of the most commonly cited reasons 鈥 relocating to a new state.
The Centers for Medicare and Medicaid Services (CMS)聽 to help consumers and those who assist them in enrolling understand what qualifies as a permanent relocation versus a temporary one.
People who聽move to a new聽state and 鈥渋ntend to reside鈥澛爐here聽may be eligible for聽a special enrollment period on the marketplace to pick a new plan. There鈥檚 no waiting period to establish residency for coverage after people move.
Still, determining residency intentions could be a head scratcher. CMS clarified that traveling to a state for business, pleasure or to get medical care will not聽meet the residency requirements for a permanent move.
People may have more than one residence and may qualify for marketplace coverage in both places.聽Someone who keeps two homes in different states and spends entire seasons or lengthy periods of time in each could sign up for marketplace coverage in either or both states after each move, according to CMS.
Students and other children younger than 21 are generally assumed to have the same state of residence as their parents. However, if 鈥測ou鈥檙e under 21, you can attest you live elsewhere and intend to reside there,鈥澛爕ou may qualify for a to buy a new marketplace plan, said Sabrina Corlette, research professor at Georgetown University鈥檚 Center on Health Insurance Reforms.
聽that people are waiting until they become sick, then claiming they鈥檙e entitled to a special enrollment period for marketplace coverage. In response, the federal government announced that a number of events , including certain errors in marketplace income and tax credit determinations.
In addition, the administration said it will examine a sample of records from consumers who were deemed eligible for special enrollment periods because of a permanent move or a loss of coverage to determine if the rules were properly applied. If consumers should not have been granted access to a special sign-up period, they could be subject to penalties for perjury, CMS said.
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