For the last 10 years, individuals who had active Deferred Action for Childhood Arrivals (DACA) status were not included in the definition of “Lawfully Present” making them ineligible to apply and enroll in the Health Insurance Marketplace.
On May 3, 2024, the U.S. Department of Health and Human Services, modified the definition of “Lawfully Present,” to include individuals with active DACA status making them now eligible to apply and enroll.
With this new update, approximately 28,610 Illinoisans (according to the U.S Citizenship and Immigration Services as of September of 2023) will now be eligible to enroll in the Health Insurance Marketplace.
Starting November 1, 2024, the same day that the 2025 Open Enrollment period begins, individuals under DACA status will qualify to enroll in the Health Insurance Marketplace. Newly eligible individuals will not only be able to apply for coverage during Open Enrollment, but they will also qualify to apply through one of the Special Enrollment Periods (SEP) if they had certain life events within the last 60 days, including losing health coverage, moving, getting married, having a baby, or adopting a child. Individuals who apply through a SEP starting November 1, 2024 could have their coverage starting as soon as December 1, 2024.
For those individuals who do not qualify to apply through a SEP, they will be able to apply during the 2025 Open Enrollment Period for coverage starting as soon as January 1, 2025. Individuals who wish to have their coverage starting that date, would need to complete the application and enroll in a qualified health plan by December 15, 2024, otherwise coverage could start February 1, 2025, or March 1, 2025, depending on the date they enroll in a qualified health plan.
Individuals with DACA status, will qualify as well for savings, depending on the household income for the year, and if they are eligible or not for health coverage through a job, if they are, it would also depend on if the health coverage meets the minimum value standard and its cost. The savings include assistance to pay the monthly premium and extra savings on deductibles, copays, and coinsurance.
Here at Greater Family Health, we are very excited about this newly eligible group, and we expect to have an increase in individuals seeking assistance starting November 1, 2024, to apply in the Health Insurance Marketplace. Patients can speak to a Health Benefits Specialist with questions.
