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Special enrollment wizard

Did you or anyone in your household lost qualifying health coverage in the past 60 days OR do you expect anyone in your household to lost coverage in the next 60 days? 

Did any of the following apply to you or anyone in your household in the past 60 days?

Changes in household size:

Got married

Had a baby

Gained/became a dependent

Got divorced or legally separated and lost health insurance

Death

Changes in residence or income:

Changed your primary place of living

Had a change in income

Gained citizenship or lawful presence in the U.S.

Denied Medicaid/CHIP

Changes in status:

Was released from incarceration (detention, jail, or prison)

Are you a member of a federally recognized tribe, or an Alaska Native corporation shareholder?

Coverage losses that qualify you for a SEP:

 

  • Losing job-based coverage for any reason, including resigning, being laid off, or getting fired

 

  • Losing coverage due to divorce or family changes

 

  • Policy/plan year ending (for a plan or policy you bought yourself)

 

  • COBRA coverage running out (or your former employer stopping contributing to your COBRA coverage, requiring you to pay the full cost)

 

  • Aging off a parent's plan by turning 26

 

  • Losing eligibility for Medicaid or CHIP

 

NOTE: Voluntarily giving up coverage or losing it because you didn't pay your premium doesn't qualify for a SEP. You also don’t qualify if you drop COBRA coverage outside of Open Enrollment before the COBRA coverage runs out.

If you lose your health coverage because of a divorce or legal separation, you qualify for a Special Enrollment Period. Divorce or legal separation without losing coverage doesn't qualify you.

If someone on your Marketplace plan dies and, as a result, you're no longer eligible for your current health plan, you'll be eligible for a Special Enrollment Period.

Moves that may qualify you for a Special Enrollment Period (SEP)

 

  • To a new ZIP code or county

 

  • To the U.S. from a foreign country or U.S. territory

 

  • To or from a shelter or transitional housing

 

  • For students, to or from where they attend school

 

  • For seasonal workers, to or from where they live and work

 

Moving only for medical treatment or vacation doesn't qualify you for a SEP.

 

Important: To qualify for a SEP, you must prove you had qualifying health coverage for at least one day during the 60 days before your move (except moves from a foreign country or U.S. territory).

Not all income changes qualify you for a Special Enrollment Period. Even if you don't qualify, you should update your application whenever your income changes. This way you'll get the right savings based on your current income.

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