If an applicant applies for Medicaid during the last open enrollment, who is eligible for the Medicaid/CHIP Denial Special Enrollment Period?

The correct answer is that those determined ineligible after applying are eligible for the Medicaid/CHIP Denial Special Enrollment Period. This provision allows individuals who applied for Medicaid but were found ineligible to enroll in a health plan through the Marketplace.

The rationale behind this is to ensure that individuals who seek coverage and follow the proper application process are not penalized for the outcomes of that process. When someone applies for Medicaid and is denied, it indicates that they may be eligible for different health insurance options, making them eligible for a Special Enrollment Period where they can then explore and select coverage through the Marketplace.

In contrast, individuals who receive immediate approval are already enrolled in Medicaid, which does not necessitate a Special Enrollment Period for additional coverage options. Those who did not apply cannot be granted the Special Enrollment Period since the eligibility hinges upon having previously made an attempt to obtain Medicaid. Lastly, those who apply during an SEP are already within a specific timeframe allowed for enrollment, so they are not part of the group targeted by the Medicaid/CHIP Denial provision.