Spear PT - 2026 Benefit Guide

You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues throughat least December 15. Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. Ingeneral, you qualifyforaSpecial EnrollmentPeriod if you’ve hadcertain qualifying life events, such as getting married, having ababy,adopting achild, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in aMarketplace plan. Thereis also aMarketplace Special Enrollment Period for individuals and their families who lose eligibility forMedicaid or Children’s Health Insurance Program (CHIP)coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals mayno longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering atemporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage. Marketplace-eligible individuals who live in states served by Healthcare.gov and either- submit anew application or update an existing application on Healthcare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a60-daySpecial Enrollment Period. Thatmeansthatif you lose Medicaid or CHIPcoverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIPcoverage. In addition, if you or your family members are enrolled in Medicaid or CHIPcoverage, it is important to makesure that your contact information is up to date to makesure you get anyinformation about changesto your eligibility. Tolearn more,visit Healthcare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.

What aboutAlternatives to Marketplace Health Insurance Coverage?

If you or your family are eligible for coverage in an employment-based health plan (such as an employer-sponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances,including if you or your dependents were enrolled in Medicaid or CHIPcoverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIPcoverageto enroll in anemployment-based healthplan. Confirm thedeadline with your employer or your employment-based health plan. Alternatively, you can enroll in Medicaid or CHIPcoverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit www.healthcare.gov/medicaid-chip/getting-medicaid-chip/ for more details.

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