• Jenn Williams

Do I Qualify for the Special Enrollment Period?

Updated: Mar 11

Unfortunately, the 2021 Open Enrollment Period is over, however, this doesn’t necessarily mean you are no longer able to enroll in or change your healthcare plan. There are numerous “life events” that may qualify you for a Special Enrollment Period, where you will be able to enroll in or change your healthcare plan.

Do I Qualify for the Special Enrollment Period? Special Enrollment Period for Health Insurance Coverage
 

What is a Life Event that Would Qualify Me for Special

Enrollment?


A life event is a sudden change in your current situation. Examples include losing healthcare coverage, having a baby, getting married, or moving to a new home, among others. These life-altering circumstances may make you eligible for a Special Enrollment Period, which allows you to enroll in a health insurance plan outside the traditional yearly Open Enrollment window.



Life Changes that Can Qualify You for a Special Enrollment Period:


Changes in Household

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

  1. Got married. Pick a plan by the last day of the month and your coverage can begin on the first day of the next month.

  2. 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 up to 60 days later.

  3. Got divorced or legally separated and lost health insurance. Please note that a divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.

  4. Died. You will only be eligible for a Special Enrollment Period if someone on your plan dies, and due to this, you’re now ineligible for the current healthcare plan.


Changes in Residence

Household alterations that may qualify you for a Special Enrollment Period:

  1. Moving to a new residence in a new county or ZIP code

  2. If you’re a student, moving to or from your school

  3. If you’re a seasonal worker, moving to or from your seasonal work residence

  4. Moving to the United States from a foreign country or U.S. territory

  5. Moving to or from a shelter or other transitional housing


Loss of Previous Health Insurance


You may qualify for the Special Enrollment Period if you, or anyone in your household, lost qualifying health coverage in the past 60 days OR since 01/01/21 OR expects to lose coverage in the next 60 days. Healthcare coverage losses that may qualify you:

  1. Losing job-based health coverage

  2. Losing your personal health coverage for a plan or policy

  3. Losing eligibility for Medicaid, Medicare, or Children’s Health Insurance Program (CHIP)

  4. Losing coverage through a family member

  5. Turning 26 and no longer being eligible for your parent’s plan


Other Qualifying Changes

Additional life-altering conditions that may qualify you for a Special Enrollment Period:

  1. Leaving jail or prison

  2. Becoming a United States citizen

  3. Starting or ending your service in the Americorps

  4. Obtaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

An Employer Offers to Help with the Cost of Coverage

You could qualify for a Special Enrollment Period if anyone in your household, or you recently acquired access to an individual coverage HRA or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days OR anticipates access to one in the next 60 days.


What if I Don’t Qualify for a Special Enrollment Period?

If you don’t qualify for a Special Enrollment Period, you may still be eligible for Medicaid or the Children’s Health Insurance Program (CHIP). You’re able to apply for these programs at any time.

If you are unsure whether you qualify for these programs…


What Do I Do if I Don’t Qualify for a Special Enrollment Period, Medicaid, or Chip?

If you’ve missed the Open Enrollment Period and also don’t qualify for any of the Special Enrollment Period circumstances listed above, you’re not necessarily out of luck! You will need to secure some sort of health coverage for you and your family as unexpected health issues or injuries can be incredibly expensive and can put a drain on your family’s financial future.


You may still be eligible for a short-term medical (STM) insurance policy. These policies were introduced for instances exactly like this, and at this point, might be your only coverage option until 2022 Open Enrollment begins in November of 2021.


Dates and Deadlines for 2022 Open Enrollment

The next Open Enrollment Period runs from Sunday, November 1st to Tuesday, December 15th, 2021. Make sure to enroll during this time to avoid having to sign up with the Special Enrollment Period, or by other means in the future.


Signing Up for a Special Enrollment Period

If you think you qualify for a Special Enrollment Period, based on this information provided above, it’s important to act fast. It’s best to be covered if an unexpected health issue arises. We work with multiple insurance companies to guarantee you the best possible plan, based on your personal needs.



6 views