Do You Qualify for A Special Enrollment Period for Health Insurance?

Since the 2021 Open Enrollment Period is over, you can now enroll in or change a health insurance plan in the Marketplace only if you have a life event that qualifies you for a Special Enrollment Period.

Here are a few examples of life changes that will allow you to qualify for a Special Enrollment Period:

Changes in household
You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

  • Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
  • Died. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result you’re no longer eligible for your current health plan.

Changes in residence

Household moves that qualify you for a Special Enrollment Period:

  • Moving to a new home in a new ZIP code or county
  • Moving to the U.S. from a foreign country or United States territory
  • If you’re a student, moving to or from the place you attend school
  • If you’re a seasonal worker, moving to or from the place you both live and work
  • Moving to or from a shelter or other transitional housing
  • Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.

Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.

Loss of health insurance

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days (or more than 60 days ago but since January 1, 2020) OR expects to lose coverage in the next 60 days.

Coverage losses that may qualify you for a Special Enrollment Period:

  • Losing job-based coverage
  • Losing individual health coverage for a plan or policy you bought yourself
  • Losing eligibility for Medicaid or CHIP
  • Losing eligibility for Medicare
  • Losing coverage through a family member
  • An employer offer to help with the cost of coverage
  • You may qualify for a Special Enrollment Period if you or anyone in your household newly gained access to an individual coverage HRA or a Qualified Small Employer Health
  • Reimbursement Arrangement (QSEHRA) in the past 60 days OR expects to in the next 60 days.

More qualifying changes
Other life circumstances that may qualify you for a Special Enrollment Period:

  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Leaving incarceration
  • Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member

Think you might qualify for a Special Enrollment Period? Contact us today! From there, we will discuss whether your major life event qualifies you and guide you through the paperwork and process to make sure you receive the healthcare coverage you need.

Source: https://www.healthcare.gov