Navigator Guide FAQs of the Week: Understanding Common Consumer Notices When Applying for Marketplace Coverage


Happy New Year! In most states, consumers have until January 15 to sign up for marketplace coverage for 2022. In this weekly installment of frequently asked questions from our updated Navigator Resource Guide, we highlight information about common notices consumers may receive when applying for marketplace coverage, and what steps must be taken to respond and successfully enroll in a health insurance plan.

The marketplace said I must submit additional information to document my eligibility (to buy coverage or to qualify for premium tax credits). They gave me 90 days. I won’t be able to gather the information that quickly. Can I request an extension?

Yes. You must request any extension before the 90-day deadline runs out. You can request the extension in writing or through the marketplace call center. In your request you should include your name, a description of the supporting documents requested, the reason you need an extension, and the amount of additional time you need. You may want to ask a Navigator for help requesting an extension.

I received a notice saying there is a data matching issue on my application and the marketplace needs to verify my income. How should I verify my income?

A data matching issue means the marketplace is not able to verify the information on your application based on the data the marketplace already has for you. To resolve the data matching issue with your application, the marketplace is likely to contact you and ask you to verify your income. You can also do so by uploading documents to the marketplace online or by sending photocopies in the mail. Verifying documents might include a federal or state tax return, a letter of termination, or pay stubs. To determine which documents you need to submit, please consult this guide here.

My insurer says I owe past due premiums for coverage and won’t enroll me for new coverage until I pay them. Is this allowed?

Yes, this is allowed. Insurers can take into account past due premiums that you owe them for coverage in the previous 12 months when you apply for a new plan. This requirement does not apply if you are signing up for coverage from a different insurer from the one to whom you owe past due premiums, and only affects the person responsible for paying premiums on the previous policy, not other family members enrolled in the plan. This applies to both open enrollment and special enrollment periods. If you think this is an error, contact your state’s marketplace or state insurance department; a list of state departments of insurance is available under our Resources, When and How to Contact Insurance Regulators.

Check back next week for more guidance on navigating marketplace coverage. In the meantime, find answers to 300+ FAQs, state-specific information, resources for diverse communities, and ask CHIR experts your private health insurance questions on the updated Navigator Resource Guide.





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