What is a Special Enrollment Period?

What is a Special Enrollment Period?

May 15 2020

If you’ve gone through certain life-changing events, you may be eligible to enroll in a health insurance plan during this period.

The open enrollment period for individual health insurance coverage typically ends in December. Unfortunately, this means you can’t enroll in a new health insurance plan until the next open enrollment period in the fall, and you won’t have access to health insurance coverage until at least January 1 of the following year.

However, if you’ve gone through certain life-changing events, you may be eligible to enroll in major health insurance during a special enrollment period.

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, or SEP. You may be eligible for a special enrollment period if you experience a qualifying life event.

What qualifies as a Special Enrollment Period?

Have you recently moved or lost coverage at work due to COVID-19 or another reason? Have you recently had a baby? Did you get married? 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. It’s important to understand that an unexpected medical event or injury does not qualify you to enroll in health insurance during a SEP.

Qualify for a SEP? Priority Health has a health insurance plan for you. Shop plans here.

Where can I buy a plan if I qualify for a Special Enrollment Period?

If you qualify for a special enrollment period, you can purchase a health plan through a trusted health insurance company or the Health Insurance Marketplace. If you need more help with choosing a plan you can contact a licensed 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.

In all cases, you’ll need to provide proof of your life event, such as a marriage or birth certificate. Due to COVID-19, if you enroll directly through Priority Health the need for documentation for loss of coverage is currently being waived. Be sure to have all required documentation ready in advance if you can. Some common examples of qualifying life event documentation include a birth or marriage certificate, a loss of coverage notice from a previous employer or a new driver’s license.

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.

If you don’t qualify, you can purchase short-term or temporary health insurance until you qualify for a special enrollment period or until the next open enrollment period comes around.

How long does the Special Enrollment Period last?

Depending on your specific circumstance, you’re only allowed 60 days from the day of your life event to change or enroll in health insurance. If you don’t take action by the deadline, you could find yourself without coverage until the next open enrollment period.

In most cases you only have 60 days from when you have a qualifying life event to buy or change your coverage. If your life changes, don’t wait to research your options. Remember to take your life changes into account when choosing the best plan for you and your family. If you lost your coverage due to COVID-19, resources to keep your coverage without any gaps are available here.

Do you qualify for a SEP and want to browse plan options? Priority Health has a plan for you.

Tags: , ,