How To Qualify For Special Enrollment
To qualify for a Special Enrollment Period outside of Open Enrollment, you typically need to experience a qualifying life event. Some of the most common qualifying life events include:
- Change or loss of employment
- Losing your existing health coverage, including Medicaid
- Moving to a new ZIP code or county
- Having a baby or adopting a child
- Becoming divorced or separated
Any circumstances that cause you to lose or experience a change in health insurance may make you eligible for a Special Enrollment Period due to a qualifying life event.
How Long Is A Special Enrollment Period?
Since a qualifying life event can happen at any time, you typically have 60 days before or 60 days following the qualifying event to enroll in a plan. In most cases, coverage must be selected by the 15th of the month to be effective the first of the following month.
There are some exceptions (birth or adoption of a child, marriage, and involuntary loss of coverage) that may have different rules for coverage effective dates. Also, when you apply, you may be required to submit documents that confirm your eligibility to enroll based on the life event you experienced.
How Soon Does My Special Enrollment Coverage Start?
Once you’ve enrolled in a health plan during a Special Enrollment Period, you’ll typically need to make your first monthly premium payment prior to the coverage beginning. In some instances, retroactive coverage may be offered based on a past date that aligns to your qualifying life event, such as the birth of a child.