CMS Officially launches $0-Premium #SecretPlatinum eligibility for those on Unemployment in 2021

Platinum Blonde

Last week I gave a heads up about the imminent launch of the American Rescue Plan's "Unemployment Insurance Benefit" provision at HealthCare.Gov:

This, again, is a Big Deal for this year. Paired with the beefed-up APTC table, what it means is that if you're on unemployment this year you effectively don't have to pay anything for a benchmark Silver plan. I'm not sure if you have to be unemployed for the full year or not...the wording above sounds like even someone who's only on unemployment for one or two weeks would still be counted as having 133% FPL.

Sure enough, just about anyone who is either currently receiving unemployment benefits or who did earlier this year (or later this year, for that matter) is likely eligible for a FREE ($0* Premium) Silver CSR 94 plan...otherwise known as #SecretPlatinum:

...Thanks to the ACA's Cost Sharing Reduction provision, if your household income is less than 250% of the Federal Poverty Line, you receive bonus financial help to cut down on deductibles, co-pays and coinsurance, broken into 3 tiers: 100 - 150% FPL; 150 - 200% FPL and 200 - 250% FPL.

The most generous of these is the 100 - 150% FPL tier; enrollees in that income range are eligible for "Silver CSR 94" plans which cut down your cost sharing so much (they cover ~94% of the average enrollee's healthcare expenses) that these Silver plans effectively become the equivalent of Platinum plans instead (Silver normally covers ~70% of expenses; Platinum covers ~90%).

The ARP doesn't literally say "Unemployment benefit recipients qualify for free Platinum plans"...what it does say is that those on unemployment automatically have their annual household income defined as being 133% FPL regardless of how much they actually earn...which in turn means they qualify for the strongest CSR tier. Furthermore, since the ARP also sets the benchmark Silver plan to cost $0/month for those earning less than 150% FPL...voila!

*NOTE: In CA, OR, WA & NY premiums cost at least $1/mo even for those earning < 150% FPL; in some other states certain plans will be $1/mo.

Several of the states which operate their own ACA exchanges have actually had this provision live for some time, such as Pennsylvania (I've been told that Rhode Island, Vermont and the District of Columbia are already live as well), but others don't go live until July 1st...including the Big One: Healthcare.Gov.

Sure enough, as I noted last week, CMS just made it official:

American Rescue Plan Lowers Health Insurance Costs for Americans Who May Have Lost Their Job

As part of the American Rescue Plan (ARP) signed by President Biden, the Centers for Medicare & Medicaid Services (CMS) is again lowering the cost of health insurance and opening more pathways for Americans to obtain affordable and comprehensive health coverage. Starting July 1, 2021, consumers who received or are approved to receive unemployment compensation for any week beginning in 2021 may be able to find even lower cost plans and save extra money on out-of-pocket expenses through HealthCare.gov.

To take advantage of these additional savings, consumers who received or have been approved for unemployment compensation in 2021 need to visit HealthCare.gov to submit a new application or update their existing application to maximize the savings they can get for the rest of 2021. An average of three out of five eligible uninsured Americans can access $0 plans after advance payments of tax credits and an average of four out of five current HealthCare.gov consumers will be able to find a plan for $10 or less per month after advance payments of tax credits. CMS encourages current consumers who have received unemployment income for any week beginning in 2021 to update their application and enrollment between July 1 and August 15to maximize the savings on their Marketplace coverage for the rest of the year.

“The Biden-Harris Administration is focused on providing relief to millions of families who need to access health insurance coverage because they have been impacted by job losses or underemployment during the pandemic,” said HHS Secretary Xavier Becerra. “The Administration has made it easier than ever for Americans to enroll in an affordable, comprehensive health insurance plans through HealthCare.gov thanks to the increased financial assistance provided through the American Rescue Plan. We encourage consumers who have received unemployment compensation in 2021 to visit the Marketplace to see if they qualify to save money on their health insurance premiums and out-of-pocket costs.”

“We are doing everything we can to remove financial barriers to comprehensive health care,” said CMS Administrator Chiquita Brooks-LaSure. “The American Rescue Plan provides consumers with additional savings and will make coverage even more attainable for those most in need. We welcome people who received unemployment benefits in 2021 to check out their health coverage options on HealthCare.gov on July 1.”

Additionally, as a result of the Biden-Harris Administration’s Special Enrollment Period for the COVID-19 Public Health Emergency, consumers can continue to apply for coverage, compare plan offerings, or learn if they qualify for more affordable premiums by visiting HealthCare.gov or CuidadoDeSalud.gov through August 15. Consumers can view 2021 plans and prices and submit an application to see if they are eligible for enrollment and financial assistance. If eligible, they can enroll in a plan that best meets their needs. Current enrollees should review their application, make any updates needed to their current information, submit their application, and then select a new plan or reselect their current plan to receive the increased savings under the ARP.

Consumers can also call the Marketplace Call Center at 1-800-318-2596, which provides assistance in over 150 languages. TTY users should call 1-855-889-4325. Consumers can also find a local assister or agent/broker in their area. Consumers who live in a state with a Marketplace that operates its own platform should visit their state Marketplace website or call center for information on accessing these additional savings through their State-based Marketplace.

UPDATE 7/01/21: Sure enough, starting today, if you use the window shopping tool at HealthCare.Gov you'll see the following additional question show up during the personal info process: