HomeSubsidized Health InsuranceEnrollment Outside Open Enrollment

Health Insurance Outside Open Enollment

 

In order to buy a Marketplace health insurance plan outside the open enrollment period, you must have a qualifying life event. Qualifying life events that create a special enrollment period include:

  • Getting married
  • Having, adopting, or placement of a child
  • Permanently moving to a new area that offers different health plan options
  • Losing other health coverage (for example due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or a health plan being decertified). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums are not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.)
  • For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions

Special enrollment periods

If you have a qualifying life event, you get a special enrollment period. This means you can enroll in or change your health insurance plan outside the open enrollment period.

Most special enrollment periods last 60 days from the date of the qualifying life event.

Open enrollment for Marketplace coverage ends March 31, 2014. The next open enrollment period is November 15, 2014 - February 15, 2015.

Medicaid and CHIP: Enroll any time

You can enroll in Medicaid or the Children’s Health Insurance Program (CHIP) in your state at any time—there is no limited enrollment period for these programs. Medicaid and CHIP provide health coverage to millions of families with limited incomes.

You can find out if you qualify for Medicaid or CHIP by filling out a Marketplace application or going directly to your state Medicaid agency.

Some states have expanded their Medicaid programs this year. If your state has expanded Medicaid, you’ll probably qualify if your income is below about $16,1050 for an individual or $32,913 for a family of 4. See if your state is expanding Medicaid.

If your state isn’t expanding Medicaid you may still be eligible, especially if you have children, are pregnant, or have a disability. Every state’s eligibility rules are different. If it looks like you’re eligible for Medicaid or CHIP, the Marketplace will pass along your information to your state agency, where you’ll be able to enroll.

Find contacts for your state’s Medicaid and CHIP programs.

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