If you've ever needed or wanted to make a change to your health plan mid-year, you may have heard those words, 'You need a Qualifying Life Event'.
What is a Qualifying Life Event?
Well surely, we can tell that it is an event that impacts your life. I know that a broken water pipe impacts my life not to mention the occasional flat tire but unfortunately, those are not 'qualifying' life events. So now we not only need a life event, but it also must qualify! Oh Boy! Oh, and don't forget…the event must have happened in the previous 60 days in most cases.
According to Healthcare.gov (the government website through which many of us enroll in our health insurance plan), these are some 'qualifying life events':
Changes in Household
You may qualify for a Special Enrollment Period if you or anyone in your household has had any of these changes in the past 60 days
- 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 for 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 be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result, you’re no longer eligible for your current health plan.
Changes in Residency
- Household moves that qualify you for a Special Enrollment Period are as followed:
- Moving to a new home in a new ZIP code or county
- Moving to the U.S. from a foreign country or the United States territory
- If you're a student, moving to or from the place you attend school
- If you're a seasonal worker, moving to or from the place you both live and work
- Moving to or from a shelter or other transitional housing
Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.
Important: 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 the 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.
Coverage losses that may qualify you for a Special Enrollment Period:
- Losing job-based coverage
- Losing individual health coverage for a plan or policy you bought yourself
- Losing eligibility for Medicaid or CHIP
- Losing eligibility for Medicare
- Losing coverage through a family member
More qualifying changes
- Other life circumstances that may qualify you for a Special Enrollment Period:
- Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
- Leaving incarceration
- Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
If you have any questions about your 'Life Events' please give us a call!
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