On September 28, 2017, the U.S. Dept. of Health and Human Services released guidance outlining new special enrollment period (SEP) rules for people affected by the 2017 hurricanes. This new guidance will provide individuals who were impacted by Harvey additional opportunities to enroll or change their ACA coverage for 2017 and additional time to enroll in coverage for 2018. This guidance only applies to coverage purchased in the Health Insurance Marketplaces created by the ACA.
This is a much welcome step by the Trump administration and could make a big difference in accessing health care for Texans impacted by Harvey.
What Does This Mean for 2017 Coverage?
Texans who experience(d) a qualifying life event between 60 days before Harvey came (official FEMA start date is August 31, 2017) and December 31, 2017 but were unable to fill out an application or complete plan selection will be eligible for a new special enrollment period. This means that people who fit these criteria can enroll in a new plan or make changes to their existing coverage for 2017 from now through December 31, 2017. Consumers can request their coverage begin retroactively, but how far back this can go will differ for each person depending on what their original SEP was and when it occurred.
In addition, HHS is waiving the requirement for individuals to provide verification before they can enroll in coverage using an SEP. According to the new guidance those residing in disaster counties will not be required to provide documentation when using this new Special Enrollment Period for 2017 coverage.
What Does This Mean for 2018 Coverage?
The open enrollment period for individuals to enroll in coverage for 2018 begins on November 1, 2017 and ends December 15, 2017. BUT people who either currently reside in a disaster affected area or did when Harvey hit will have until December 31, 2017 to enroll in 2018 coverage.
Which Counties Are Included?
The guidance makes these new SEPs available to individuals who “reside, or resided at the time of the hurricane, in any of the counties declared as meeting the level of “individual assistance” or “public assistance” by FEMA.” According to FEMA’s website this includes the following Texas counties:
Aransas, Austin*, Bastrop, Bee, Bexar*, Brazoria, Burleson*, Calhoun, Chambers, Colorado, Dallas*, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Grimes*, Hardin, Harris, Jackson, Jasper, Jefferson, Karnes, Kleberg, Lavaca, Lee, Liberty, Madison*, Matagorda, Montgomery, Newton, Nueces, Orange, Polk, Refugio, Sabine, San Jacinto, San Patricio, Travis*, Tarrant*, Tyler, Victoria, Washington*, Walker, Waller, Wharton
*These counties were designated as eligible for “public assistance” only but are still considered “affected” and therefore people in these counties are eligible for the SEPs.