HealthCare.gov Special Enrollment Period Helps Those 100% to 150% of the Federal Poverty Level Get Covered

Health insurance navigators are ready to help those eligible navigate HealthCare.gov

Raleigh, N.C. – The health insurance navigators of the NC Navigator Consortium are providing free help for North Carolinians that qualify for a Special Enrollment Period (SEP) on the Health Insurance Marketplace® at HealthCare.gov, currently open to families who make 100% to 150% of the Federal Poverty Level (FPL). The SEP was opened earlier this year to low-income individuals and families who may benefit from low costs through the American Rescue Plan. The NC Navigator Consortium’s federally qualified health insurance navigators are scheduling appointments (by phone, in person or virtually) at ncnavigator.net or 1-855-733-3711. 

The SEP is available to eligible people who have applied for HealthCare.gov coverage since Open Enrollment ended and who didn’t have access to another SEP from a qualifying life event. The new SEP will allow eligible consumers to enroll in HealthCare.gov coverage at any time, and possibly qualify for more savings. The FPL annual household income varies by state and household size. According to the Assistant Secretary for Planning and Evaluation (ASPE), in North Carolina:

For a household/family size of:150% of the FPL is:
One $20,385
Two$27,465
Three$34,545
Four$41,625

“Last year’s Open Enrollment period was very busy for our statewide network of local health insurance navigators,” said Mark Van Arnam, director of the NC Navigator Consortium. “We know uninsured North Carolinians need and want this coverage, but don’t know they can apply now to get coverage that is more affordable than ever.”

Started in 2014, the NC Navigator Consortium is a nonpartisan, nonprofit group of organizations whose health insurance navigators give peace of mind to those seeking free, unbiased help finding quality, affordable coverage. Navigators connect consumers to qualified health plans that provide essential health benefits and preventive care, in addition to mental health care, ER care and maternity coverage, not limited by caps or pre-existing conditions. These benefits are covered in all policies available on HealthCare.gov, the federal Health Insurance Marketplace® established by the Affordable Care Act. Tax credits and subsidies made possible by the American Rescue Plan have lowered premiums, making Marketplace plans very affordable.

Though the Marketplace has increased access to health insurance coverage for millions, trying to enroll or update one’s coverage through the Marketplace can be confusing and overwhelming. Health insurance navigators help North Carolinians maximize their coverage by:

  • Taking time with them to help avoid mistakes
  • Showing all options, ensuring their providers are in-network
  • Explaining terminology and processes, increasing health insurance literacy
  • Assisting them with estimating their income for the year ahead, one of the most difficult parts of the HealthCare.gov application process

Navigators are available year round for questions and to address other issues like qualifying life events, special enrollment periods and income adjustments.

The NC Navigator Consortium is the only federally funded entity of its kind in North Carolina, supported in part by the Centers for Medicare & Medicaid Services. Learn more at ncnavigator.net, and follow on Facebook, Twitter and Instagram. Members of the Consortium are Access East, Charlotte Center for Legal Advocacy, Council on Aging of Buncombe County, Cumberland HealthNET, HealthCare Access, HealthNet Gaston, Kintegra Health, NC FIELD and Pisgah Legal Services. The Consortium is led by Legal Aid of North Carolina

Legal Aid of North Carolina is a statewide, nonprofit law firm that provides free legal services in civil matters to low-income people in order to ensure equal access to justice and to remove legal barriers to economic opportunity. Learn more at legalaidnc.org and follow on Facebook, Twitter, Instagram, LinkedIn and YouTube

The project described was supported by Funding Opportunity number CA-NAV-21-001 from the Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health & Human Services or any of its agencies.