A qualifying life event is a change in your situation, like getting married, having a baby, or losing health coverage. Specific qualifying events include:
Changes in household
You may qualify for a Special Enrollment Period if in the past 60 days you or anyone in your household:
- Got married. Pick a plan by the last day of the month, and your coverage can start the first day of the next month.
- Had a baby, adopted a child, or placed a child in foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
- Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
- Died. You’ll qualify for a Special Enrollment Period if someone on your Marketplace plan dies which causes you to lose your current health plan.
Changes in residence
You may qualify for a Special Enrollment Period if you move to:
- New home in a new ZIP code or county
- The U.S. from a foreign country or the United States territory
Or, move to or from:
- Place you attend school (if you're a student)
- Place you both live and work (if you're a seasonal worker)
- Shelter or other transitional housing
Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.
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.
Loss of health insurance
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
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
- Coverage through a family member
- Eligibility for Medicare
If you lost coverage more than 60 days ago, but since January 1, 2020, and didn’t enroll sooner because you were impacted by the COVID-19 emergency declared by FEMA, you may still qualify for a Special Enrollment Period.
An employer offer to help with the cost of coverage
You may qualify for a Special Enrollment Period if you (or anyone in your household) were offered an ICHRA in the past 60 days OR expects to in the next 60 days.
More qualifying changes
Other situations that may qualify you for a Special Enrollment Period:
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming a U.S. citizen
- Leaving incarceration
- Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
For more information, please visit the Healthcare.gov website detailing this.