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Special Enrollment Period (SEP) - Losing HBIA/HBIS Coverage
Due to a change in eligibility policy, individuals with the status of: Lawful Permanent Resident (green card holder) who have been in the United States for less than five years (LPR), will no longer be eligible for the Health Benefits for Immigrant Adults (HBIA) and Health Benefits for Immigrant Seniors (HBIS) programs effective April 30, 2024. These individuals are eligible for subsidies on the federal health insurance marketplace.
Special Enrollment Period (SEP) on the ACA Health Insurance Marketplace if you lost Illinois HBIA/HBIS coverage:
If you are no longer eligible for HBIA/HBIS in Illinois because you are a legal permanent resident and have been in the U.S. for under five years, you are eligible for a Special Enrollment Period to purchase a quality, affordable health plan on the ACA Health Insurance Marketplace.
- GetCoveredIllinois.gov is the official Affordable Care Act (ACA) Health Insurance Marketplace for the state of Illinois which offers free enrollment assistance to help you find the right health plan to fit your needs and we can help you find out if you qualify for financial help through premium tax credits.
- You can also go directly to Healthcare.gov to purchase a plan on the ACA Health Insurance Marketplace.
If you have questions about your Illinois HBIA/HBIS coverage, please refer to the letter you received from the Illinois Department of Healthcare and Family Services (HFS) for instructions, or log into your account at abe.illinois.gov, or call 800-843-6154.
FAQs
- If I’ve lost HBIA/HBIS coverage, am I eligible for an ACA Marketplace Special Enrollment Period (SEP)?
- How can I access this SEP?
- When will coverage start if I am eligible for the SEP?
- Is there a new application question I have to answer to be determined eligible for the SEP?
- What steps should I take to make sure I can be determined eligible for the SEP?
- Will I need to provide documentation to verify my eligibility for the SEP?
- How do I qualify for financial assistance (also known as subsidies) through the ACA Marketplace?
- What should I do if I’m not sure whether my HBIA/HBIS coverage was terminated?
- Does applying or enrolling in an ACA Marketplace health plan, including receiving financial help, make an individual a public charge?
If you are a Legal Permanent Resident (LPR) who has been in the United States for less than five years, you will be eligible for Affordable Care Act (ACA) Health Insurance Marketplace coverage, which provides subsidies to noncitizens who are lawfully present in the country.
You can access ACA Marketplace coverage by going to our shop and enroll page. We encourage anyone in need of assistance with enrollment to connect with a trained Navigator by choosing “Get Free Help” on our home page menu. On the Get Covered Connector page, you can type in your zip code to find local enrollment help in your area and choose your language preference.
Coverage will start the first of the month after you apply. For example, if you apply on April 26, your coverage will start on May 1.
There is a question on the application that asks if you have been denied Medicaid. If you have lost HBIA/HBIS coverage, you will answer yes.
Have your documents ready. The online application will ask if you have eligible immigration status. If you are a Legal Permanent Resident (LPR) who has been in the United States for less than five years, answer yes. The marketplace must verify that applicants are ineligible for Medicaid based on their immigration status before determining their eligibility for financial help. You can also talk with a local Navigator or the call the ACA Marketplace regarding your eligibility for other SEPs.
If HealthCare.gov can’t electronically verify your immigration status, you will need to provide documentation.
On the ACA Marketplace, health insurance premium amounts are dependent on household income. Based on income, individuals and families may be eligible for financial help to pay their monthly premium . There is cost sharing for covered services.
You have the right to talk with a caseworker by calling 877-805-5312.
Applying for ACA Marketplace coverage will not affect an individual’s chances of becoming a U.S. citizen. The information that an individual uses to apply for an ACA Marketplace plan may be used only for the operations of that program. It will not be used for immigration enforcement purposes. Government workers, Navigators, application assisters and individuals that help with applications are required by law to keep the information they receive private and secure.
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