If you already have coverage through the Marketplace, the rules in your Marketplace health plan for treatment for the coronavirus disease 2019 (COVID-19) emergency remain the same as any other viral infection, but your health insurance company may have added benefits.
- See what Marketplace plans cover. All Marketplace plans cover treatment for pre-existing medical conditions and can’t terminate coverage due to a change in health status, including diagnosis or treatment of COVID-19.
- Check with your health insurance company for their specific benefits and coverage policy.
- Log in to update your Marketplace application if COVID-19 impacts your income or household. You may be able to change your plan if certain situations apply.
If my state is reopening
First, check with your doctor on whether it’s safe to resume in-person visits. While they’ll continue to use telehealth services when available and appropriate, they’ll offer more in-person health care services for non-emergency and non-COVID-19-related care.
To lower exposure risk, you may experience these changes during your visit:
- Waiting in your car until the start of the visit
- Using a limited entrance
- Being screened for COVID-19 by having your temperature checked
- Avoiding waiting rooms and areas
- Maintaining social distancing
- Wearing a face covering, which will be provided to you, if you don’t have your own
If I lost my job or experienced a reduction in hours
If you lost your job-based health plan: You may qualify for a Special Enrollment Period if you lost health coverage through your employer or the employer of a family member in the past 60 days OR you expect to lose coverage in the next 60 days, including if you lose health coverage through a parent or guardian because you're no longer a dependent. In addition, you may qualify for a Special Enrollment Period if you lost health coverage through your employer more than 60 days ago but since January 1, 2020 and were prevented from enrolling in health coverage due to the national emergency on COVID-19. Note: Since FEMA declared an emergency due to COVID-19, if you lost coverage more than 60 days ago, you only qualify for a Special Enrollment Period if you missed the deadline to enroll due to being impacted by the national emergency on COVID-19. Voluntarily dropping coverage doesn't qualify you for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan.
- If your employer reduced the hours you work and you’re enrolled in a Marketplace plan: Update your application immediately within 30 days to report any household income changes. You may qualify for more savings than you’re getting now. Learn how to report changes.
- If you were furloughed: In some situations depending on the status of your health coverage from your employer, you may qualify for a Special Enrollment Period. You may be eligible for a premium tax credit to help pay for Marketplace coverage too. Create an account or log in to start your Marketplace application to find out if you qualify.
- Need help estimating your income? Use this income calculator to make your best estimate.
- If you have COBRA continuation coverage:
- If you’re entitled to COBRA continuation coverage after you lost your job-based coverage, you may still qualify for a Special Enrollment Period due to loss of coverage. You have 60 days after your loss of pre-COBRA job-based coverage to enroll in Marketplace coverage. You may also qualify for premium tax credits if you end your COBRA continuation coverage, or if you didn’t accept it to begin with.
- If you're enrolled in COBRA continuation coverage, you may qualify for a Special Enrollment Period if your COBRA continuation coverage costs change because your former employer stopped contributing, so you have to pay full cost. Learn more about COBRA continuation coverage and the Marketplace.
- If you lost your job, but didn’t also lose health coverage, because your former job didn’t offer coverage: You generally won't qualify for a Special Enrollment Period. By itself, a job loss (or a change in income) doesn't make you eligible for a Special Enrollment Period to enroll in Marketplace coverage. See if you qualify for a Special Enrollment Period another way.
Coverage start dates with a Special Enrollment Period due to loss in coverage
- If you’ve already lost coverage, your Marketplace coverage can start the first of the month after you apply and enroll.
- If you know you’ll lose coverage within the next 60 days, you can submit an application on HealthCare.gov before you actually lose your coverage to help make sure there’s no gap in coverage. For example, if you know you’ll lose coverage on April 30, and apply and enroll in a Marketplace plan April 10, your new coverage will start May 1.
If I can’t pay my premiums because of a hardship due to COVID-19
- Check with your insurance company about extending your premium payment deadline or ask if they will delay terminating your coverage if you can’t pay your premiums.
- Most of the time, if you aren’t receiving financial assistance with your premiums, you have a grace period determined by state law (often one month). If you’re getting financial assistance, you have a three-month grace period during which your coverage can’t be terminated for not paying your premiums.
- If your household income has changed, update your application immediately. You could qualify for more savings than you're getting now.
If my insurance company lowers my premium temporarily
Due to the COVID-19 emergency, some insurance companies (with prior approval from the Marketplace and their state) can lower health plan premiums for a month or more in 2020 (called a “temporary premium reduction”). They can do this as long as it’s a fixed percentage off the total premium (like 15%) and is given to all members, regardless of plan type or eligibility for advance payment of the premium tax credit (APTC).
- If you’re newly enrolling in a Marketplace plan with a premium tax credit, any temporary premium reductions that plans may offer won’t be displayed on HealthCare.gov.
- If you’re already enrolled in a Marketplace plan with a premium tax credit and your insurance company gives you a temporary premium reduction for certain months, the Marketplace may also lower your monthly APTC amount so that it doesn’t exceed the portion of your monthly premium that counts toward coverage for essential health benefits. You’ll see any adjustments to APTC in Form 1095-A, which you’ll use to reconcile your 2020 taxes that you’ll file in 2021. (Form 1095-A will be mailed to you in early 2021.)
If I’m enrolled in a Marketplace plan and my income has changed
- If you’re enrolled in a Marketplace plan and your household income has changed, update your application immediately. If your income goes down or you gain a household member:
- You could qualify for more savings than you’re getting now. This could lower what you pay in monthly premiums.
- You could qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).
- Need help estimating your new income? Use our income calculator to make your best estimate.
If I previously qualified for a Special Enrollment Period, but missed the deadline because I was impacted by the COVID-19 national emergency
Since FEMA declared an emergency due to COVID-19, if you qualified for a Special Enrollment Period more than 60 days ago but missed the deadline to enroll due to the FEMA national emergency for COVID-19, you may be eligible for another Special Enrollment Period. Visit FEMA.gov for information about emergencies in your state.
If you lost coverage more than 60 days ago but since January 1, apply online through HealthCare.gov to see if you qualify. For other special enrollment periods you missed due to COVID-19, contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to see if you’re eligible. Note: You may be asked to submit documents to confirm the loss of coverage. Documents must show that you lost coverage since January 1, 2020.
If I want to change my current Marketplace plan or enroll for the first time
- If you’ve had qualifying life changes, like if you move, have a baby, or lose other health coverage, you may be able to enroll in Marketplace coverage for the first time or change your current plan through a Special Enrollment Period.
- Answer a few questions to find out if you can enroll in or change your coverage.
If my child is now living with me after their college sent them home early
- Your child can generally qualify for a Special Enrollment Period due to change in residence if they’re:
- Still enrolled in a student health plan, but the coverage and benefits don’t extend to your area, or if your child’s move home means that they moved to a new ZIP code or county.
- Had qualifying health coverage or lived in a foreign country or a U.S. territory for at least one of the 60 days before the date of their move. Note: This requirement doesn’t apply to members of a federally recognized tribe or Shareholders of Alaska Native Corporations.
- If your child is under 26 and you’re already enrolled in Marketplace coverage, you may be able to add your child to your plan.
- If you have Marketplace coverage with savings and don’t plan to claim your child as a tax dependent on your federal tax return, your child should set up their own Marketplace account and submit a separate application.
- If you plan to claim your child as a tax dependent on your federal tax return, and you currently have Marketplace savings with your coverage, you can update your Marketplace application and add your child.
- If you have Marketplace coverage without requesting savings, you can put everyone on one application.
If I get a direct deposit or check from the IRS that is called an economic impact payment
The Coronavirus Aid, Relief, and Economic Security (CARES) Act calls for the IRS to make economic impact payments of up to $1,200 per taxpayer and $500 for each qualifying child. If you get one of these payments, you don't need to include it in the income you report on your HealthCare.gov application. These payments don't impact your eligibility for financial assistance for health care coverage through the Marketplace, or your eligibility for Medicaid or the Children’s Health Insurance Program (CHIP). For more information, visit IRS Coronavirus Tax Relief information.
For the latest COVID-19 information
- CDC.gov/coronavirus has the latest public health and safety information from CDC and for the overarching medical and health provider community on COVID-19.
- Coronavirus.gov is the source for the latest information about COVID-19 prevention, symptoms, and answers to common questions.
- USA.gov/coronavirus to see what the U.S. Government is doing in response to COVID-19.