Beginning this year, consumers will have an extra 30 days to review and choose health plans through Open Enrollment, which will run from November 1, 2021 through January 15, 2022, on HealthCare.gov. CMS is also expanding services provided by Federally-facilitated Marketplace (FFM) Navigators—experts who help consumers, especially those in underserved communities, understand their benefits and rights, review options, and enroll in Marketplace coverage. Additionally, CMS will re-launch its “Champions for Coverage” program. The program currently includes more than 1,000 local organizations that are active in providing outreach and education about the Health Insurance Marketplace and how consumers can enroll in coverage through HealthCare.gov, Medicaid, or the Children’s Health Insurance Program (CHIP).
CMS’ Final Rule on the 2022 Payment Notice expands Navigator services to help reduce health disparities. Navigators in FFMs will now provide consumers with information and assistance on certain post-enrollment topics, such as the Marketplace-eligibility appeals process and Marketplace-related components of premium tax credit reconciliation. CMS will support more outreach and engagement through modest increases to Marketplace issuer user fee rates. All 2022 Marketplace user fee rates remain lower than those for 2021, which should help keep premiums low. Additionally, four times as many Navigators—1,500 in all—will be available for consumers who use HealthCare.gov for the 2022 plan year thanks to $80 million in grant funding provided earlier this year by CMS.
In addition to extending the Open Enrollment Period and supporting the work of Navigators, CMS established a new monthly special enrollment period targeting certain low-income individuals in Marketplaces through HealthCare.gov. This opportunity provides the vast majority of eligible consumers with one or more options to enroll in free or very low-cost plans thanks to provisions in the American Rescue Plan.
The provisions CMS announced also include important flexibilities for state partners. For example, state Marketplaces with their own eligibility and enrollment platforms will be able to set their own annual Open Enrollment Period end dates, so long as these dates are on or after December 15, 2021.
All providers should remind their staff to check for changes to every patient’s insurance on a regular basis, regardless of any action from CMS.