Open Enrollment

Low-Income Special Open Enrollment for Health Insurance in NC

Having health insurance is pretty much a necessity in this day and age. After all, you never know when unexpected events may occur that warrant you or a loved one receiving immediate medical attention. While hospitals are required, per the Emergency Medical Treatment & Labor Act (EMTALA), to provide patients with stabilizing treatment, this can only get you a certain degree of care. If you don’t currently have health coverage, are of limited means, and are experiencing a life-changing event (as we’ll describe below), it’s time to let our health insurance brokers in Raleigh, NC at Carolina Insurance Professionals help you navigate the low-income special open enrollment period and get you covered.

What Is the Special Enrollment Period for Health Insurance?

Each year, there’s an Open Enrollment Period in which any individuals interested in signing up for health insurance can do so. However, the Special Enrollment Period (SEP) is only available to those who experience different life-changing events. 

Life changes that may entitle North Carolina residents to secure a health plan during the low-income special open enrollment period include qualifying events such as:

  • Moving or relocation (to another state)
  • Loss of employer-provided health insurance
  • Household changes like the birth of a child or adoption, marriage or divorce, the passing of a family member, etc
  • If your household income becomes significantly reduced

What Is the Household Income Requirement Required To Apply for Health Insurance During the Special Enrollment Period

The Special Enrollment Period (SEP) makes it simple for low-income individuals and families to enroll in a healthcare marketplace plan outside of the Open Enrollment Period. Low-income individuals wishing to qualify for this SEP must be within the 150% federal poverty level and enroll in an on-exchange health insurance plan. You’re likely to qualify to enroll during this special open enrollment period if your household size and income are as follows:

  • An individual who makes less than $20,385
  • Household size of two that makes less than $27,465
  • Household size of three that makes less than $34,545
  • Household size of four that makes less than $41,625

If your earnings are over this amount, don’t fret. Healthcare insurance may still be economically feasible for you. You may qualify for a healthcare subsidy that allows you to purchase a cost-sharing reduction plan. Plans like these offer mandatory coverage for certain types of examinations and procedures to ensure you receive essential care.

When Does the Special Enrollment Period Start and End?

In the case of 2023, the open enrollment period ran from November 1, 2022, through January 15, 2023. Those are generally the same dates this period runs each year. 

The low-income special open enrollment period often starts either 60 days prior to or following the qualifying event. The special enrollment for job-based plans is generally only 30 days, though. Certain government-sponsored medical plans like the Children’s Health Insurance Program (CHIP) and Medicaid allow potential insureds to enroll any time.  

Getting Insurance During the Special Enrollment Period Is Simple!

If you have experienced one of the life-changing events described above and/or you believe your household income falls within 150% of the federal poverty level, you likely qualify for a subsidy. Give our team of licensed health insurance agents at Carolina Insurance Professionals a call today to confirm that you qualify for this special open enrollment period to learn what the next steps are that you should take to enroll. There is no charge for our North Carolina health insurance brokers’ assistance!

What Do I Need To Get Medical Coverage During the Special Open Enrollment Period?

You’ll need to have the following information handy when attempting to purchase a subsidized health insurance plan through the Affordable Care Act (ACA) marketplace, also known as the Healthcare Exchange:

  • Social Security numbers for everyone that will be on the health insurance plan
  • Estimated household income for the upcoming year
  • Names of doctors or hospitals that you want in-network coverage for on the medical insurance plan

It’s important to note that when you sign up for coverage as a low-income individual during the special enrollment period, subsidies you qualify for based on your stated household income are immediately applied to your selected plan. However, there is an income verification process that the state or federal government performs afterward to confirm the data you supplied. If there are any discrepancies found during that automatic income verification process, you’ll be asked to provide documentation proving your financial predicament within 90 days of the request being made.

Contact us at Carolina Insurance Professionals in Raleigh about the Special Enrollment Period if you’re experiencing financial challenges that qualify you as low-income per the government guidelines above. Our North Carolina health insurance brokers will go over plans that meet your needs and budget to ensure you and your family are protected no matter what circumstances you find yourselves in.