Individual and Family Special Enrollment Periods

A Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period (OEP) when you can sign up for health insurance. You qualify for an SEP if you’ve had certain life events, such as changes in household or residence or loss of health insurance, including loss of group health coverage.

Loss of Health Insurance

You may qualify for a Special Enrollment Period if you lost job-based coverage; individual health coverage; Medicaid or the Children’s Health Insurance Program (CHIP) coverage (or were denied Medicaid/CHIP); eligibility for Medicare; or coverage through a family member.

Loss of individual health coverage includes loss of group coverage. If you or anyone in your household is losing group coverage, they have an SEP that begins 60 days before they lose coverage and lasts for 60 days after the loss of coverage date. The effective date for the plan you enroll in will be the first of the month following enrollment. Voluntary loss of coverage does not grant SEP.

Changes in Household

You may qualify for an SEP if in the past 60 days you or anyone in your household got married; had a baby, adopted a child, or placed a child for foster care; got divorced or legally separated and lost health insurance; or died. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.

Changes in Residence

You may qualify you for an SEP if you move to:

  • A new home in a new ZIP Code or county

  • The US from a foreign country or United States territory

Move to or from:

  • A place you attend school if you're a student

  • A place you both live and work if you're a seasonal worker

  • A shelter or other transitional housing

Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for an SEP.

You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don't need to provide proof if you’re moving from a foreign country or United States territory.

Call us at 1-866-322-2824 if you are losing coverage or have questions about qualifying life events and SEPs. 

Source: https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/

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