Special Enrollment Period – What’s a Qualifying Life Event?

Special Enrollment Period – What’s a Qualifying Life Event?

Feb 01 2016

In 2015, nearly 950,000 Americans had the opportunity to gain or change health insurance coverage during a special enrollment period, according to Obama Care Facts.

The 2016 open enrollment period for individual health insurance coverage ended on Jan. 31. Unfortunately, this means you can’t enroll in a new health insurance plan until the next proposed open enrollment period in the fall of 2016. And, you won’t have access to health insurance coverage until at least Jan. 1, 2017.

But what happens if your coverage needs change following a major life event?

The Affordable Care Act allows you and your family members the opportunity to enroll or change health coverage outside of the open enrollment period through a special enrollment period.

Do you qualify for a special enrollment period?

Have you recently had a baby? Got married? Lost coverage at work? Qualifying life events are vast and varied. And whether or not they’re expected, if you’ve experienced a qualifying life event you may be eligible for a special enrollment period. Note, it is important to understand that an unexpected medical diagnosis or injury does not qualify you to enroll in health insurance during a special enrollment period. This is a common misconception.

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You qualify. Now what?

If you qualify for a special enrollment period, you can purchase any individual or family health plan through a trusted health insurance company or with the assistance of an agent. Wondering if you qualify for a subsidy? You will need to apply through the Marketplace to reduce the cost of your monthly premiums or deductible.

If you’re currently enrolled in a plan, you’ll need to report your life change to your health insurance company. They can provide helpful information about next steps and can point you toward resources to get your plan adjusted to fit your new needs.

In all cases, you’ll need to provide proof of your life event, such as a marriage or birth certificate, so make sure to have those documents handy when applying.

Whichever route you take, carefully consider your life change when making your selection. Are you adding new family members such as a spouse or child to your coverage? Has your income changed? Evaluate your coverage options to purchase a health plan that supports the needs of you and your family.

Don’t wait!

Depending on your specific circumstance, you’re typically allowed 30-60 days from the day of your life event to change or enroll in health insurance. If you forgo taking action by the deadline, you could find yourself without coverage until the next open enrollment period.

If you don’t qualify, you may want to consider applying for short term or temporary health insurance until you qualify for a special enrollment period.

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