Individual & Family Health Insurance

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Life events that may qualify you for a Special Enrollment Period for Individual and Family Health Insurance.

  • Getting married
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
  • Losing other health coverage
  • Examples of losing coverage that qualify you for a Special Enrollment Period:
  • Losing job-based coverage for any reason:
  • Your employer stops offering coverage
  • You leave your job by choice
  • You get laid off or fired
  • Quitting a plan before the year ends doesn’t qualify.Losing coverage through a divorce

COBRA coverage ending (Note: If you cancel COBRA before it ends you don’t qualify for a Special Enrollment Period.)

  • Turning 26 and losing coverage under a parent’s plan
  • Losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)(including your child aging off CHIP)
  • Be careful about dropping coverage

If you voluntarily drop coverage before the plan year ends: You don’t qualify for a

  • Special Enrollment Period. You also don’t qualify if you lose coverage because you don’t pay your premium.
  • If you don’t renew a job-based plan when its plan year ends:You do qualify for a Special Enrollment Period to buy a Marketplace plan. Very important: If the job-based plan you don’t renew is considered affordable and meets minimum, you won’t qualify for a premium tax credit that lowers the cost of your plan.
  • Moving to a new residence
  • Gaining citizenship or lawful presence in the U.S.
  • Leaving incarceration
  • For people already enrolled in Marketplace coverage:
  • Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
  • Note:Voluntarily quitting a Marketplace plan mid-year doesn’t qualify you for a Special Enrollment Period.
  • FYIMembers of federally recognized Indian Tribes or Alaska native shareholders can enroll in or change plans once per month any time of year (not just during Open Enrollment).

Disclaimer: These events and conditions can change at any time.