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Qualifying For A Special Enrollment Period

Have you wondered what happens if I don’t enroll during Open Enrollment 2018? Are there any special circumstances where I can get health insurance after Open Enrollment?

The answer is yes. Yes, you can get health insurance outside of Open Enrollment but only if you qualify. This is called a SEP or Special Enrollment Period.

Here is how you 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.
  • Death. 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
  • A student moving to or from the place they attend school
  • A seasonal worker moving to or from the place they both live and work
  • Moving to or from a shelter or other transitional housing

Losing job-based coverageLosing individual health coverage for a plan or policy you bought yourselfLosing eligibility for Medicaid or CHIPLosing eligibility for MedicareLosing coverage through a family member It is important to note that when you apply, you must attest that the information you provide on the application is true, including the facts that qualify you for a Special Enrollment Period. You may be required to provide documents that prove your eligibility to enroll based on the life event you experienced.

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source:https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/#household

 

2024