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‘Life Event’ Coverage Changes: What to Know

By Lisa ZamoskySeptember 15, 2015
From the WebMD Archives

Open enrollment for Obamacare runs from Nov. 1 through Jan. 31 for 2016 coverage. But under the law, life changes, such as losing a job, having a baby, moving, divorcing and getting married, allow people to sign up for health insurance outside of the annual open enrollment period.

Here are some of the most common events that qualify you for a special enrollment period under Obamacare, and some details about signing up.

1. Losing insurance. There are many reasons for losing insurance, such as the loss of a job-based plan, aging out of a parent’s coverage at the age of 26, losing insurance through divorce, or losing eligibility for Medicaid.

2. Moving. Most health plans operate within a specific geographic area. If you permanently move to a new city or ZIP code and the number of plans offered in the new area is different – more or less – than your previous location, that’s considered a qualifying life event. The reasoning is that with these different choices available to you, it’s possible you may have made a different selection.

3. Change to family size or income. A change in your family’s size or income can affect your eligibility for tax subsidies. That may allow you to lower your insurance costs, or qualify for Medicaid.

If you get married, give birth to or adopt a child, you can add your new family members to your plan. And, if you’ve recently divorced and lost health insurance in the process, you’ll also qualify to buy a new policy during a special enrollment period.

4. Look beyond COBRA. Many people aren’t aware that after leaving or losing their job they can sign up for a plan sold through their state’s health insurance marketplace and possibly get a tax credit to lower their insurance costs. That’s likely a much less expensive option than continuing your current job-based health plan through COBRA (the Consolidated Omnibus Budget Reconciliation Act).

Also, keep in mind that with COBRA, you’ll have to hold onto that policy until it ends or the next annual open enrollment when you can sign up for a new policy. Canceling COBRA before it expires does not count as a qualifying event triggering a special enrollment period.

5. Act fast. You have only 60 days from the date of your qualifying event to sign up for a new health insurance policy. Don’t delay.

Not sure if you qualify for a special open enrollment period? Check the Healthcare.gov online screening tool.

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