Year-Round Enrollment Through the Medicaid Gap Special Enrollment Period (SEP) Webcast

02/28/2020 - 02/28/2020

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Please join us on Friday, February 28 from 11:00AM – 12:30PM CST for the next OE webinar titled Year-Round Enrollment Through the Medicaid Gap Special Enrollment Period (SEP). As many of you know, most low-income adults in Texas do not have access to health care coverage that the ACA was designed to provide. This lack of access has created the Medicaid Gap, which all Assisters in Texas grapple with every day. However, in states where Medicaid was expanded, a low-income individual may enroll in Medicaid, but lose that coverage if they return to work due to an increase in income. Due to the loss of coverage SEP, this person in an expansion state can shift from Medicaid to Marketplace coverage. In 2016, CMS created an SEP designed for non-expansion residents who have experienced a change in income that makes them newly eligible for Marketplace-based financial assistance. This webinar will provide Assisters with a thorough understanding of this SEP, the clients who should be eligible and best practices for how Assisters can most expediently request and successfully enroll a client in the Marketplace under the Medicaid Gap SEP. 

Speaker:  Arianna Anaya,  Health Coverage Program Manager, Foundation Communities

Learning Objectives:

  1. Ensure participants have a full understanding of how the Marketplace application and Marketplace based financial assistance work in terms of an applicants’ income estimate and eventual reconciliation when they file their taxes.
  2. Ensure participants understand the background and information on the Medicaid Gap SEP.
  3. Learn a step-by-step process for the completion of an application for a Medicaid Gap SEP and how to request the SEP via the Marketplace call center.


For more information contact Sonia Lara.