How to Qualify for Late Enrollment and Get a New Health Plan

 

January 31st came and went. You left yourself post-it notes and Google calendar reminders, but you still forgot to sign up for open enrollment. This mishap occurs every year to countless Americans. For many, it disrupts their health coverage and causes them to pay a penalty.

However, some people may have the opportunity to qualify for late enrollment and still obtain healthcare insurance. The ACA allows US citizens to qualify for health insurance outside of the open enrollment under what’s called the Special Enrollment Period.

In order to successfully get coverage after the enrollment window closes, you’ll need to determine if you’ve had a Qualifying Life Event (QLE), and provide proof for that event. To help you navigate the late enrollment criteria, we’ve outlined the four kinds of QLEs under the Affordable Care Act. Read on to learn more.

1. You’ve Experienced a Significant Change in Your Household Dynamics.

Changes in household, specifically having a baby, adopting a baby, getting married, or getting divorced, qualify you to apply for health insurance during the Special Enrollment Period. To start your application, visit Healthcare.gov and answer the screening questions.

During the application process, you’ll be asked to provide evidence of your child’s birth or adoption, your marriage, or divorce. The government will verify the evidence you provide, review your marketplace applications, and then decide if you qualify for late enrollment and coverage.

2. You’ve Recently Lost Health Coverage.

There are many, often unfortunate reasons people lose their health care. The ACA Special Enrollment Period tries to accommodate those people in the event that they’ve lost their eligibility for Medicare, Medicaid, or CHIP, or that they’ve turned 26 and lost coverage under their parents’ health insurance.

The late enrollment criteria also accommodates applications from people who have lost health coverage from lapsed student plans, former employment plans, and individual plans.

3. You’ve Recently Changed Your Residence.

The ACA late enrollment criteria allows for many kinds of relocation experiences. For example, you may qualify to apply under the Special Enrollment Period if you’ve moved to a new ZIP code or county.

You also may qualify if you’re a student who is moving to and from a place where you’re attending school. Seasonal workers who need to move between locations throughout the year may also qualify, as well as people moving out of transitional housing or a shelter.

4. You’ve Completed a Government Service Commitment, Incarceration, or Similar Term. Or, You’ve Just Become a US Citizen.

The four and final QLE criteria combines many different kinds of life events. Perhaps the most common qualifying event is a change of income. If your employment status has changed in some way (namely, you’ve changed positions or lost your job) and your income has been affected, then you can apply under the Special Enrollment Period.

You can also apply if you’ve just finished an AmeriCorps commitment, just gotten out of jail, just became a US citizen, or just been granted membership to a federally recognized tribe.

Before you give up on enrollment this year, review this outline that explains how you can qualify for late enrollment. At Confie, we encourage you to explore different types of health insurance. Our team can help you locate the ideal healthcare insurance, and walk you through the application process. To learn more about health insurance coverage, contact us today at 201-880-7902.