Getting Coverage Outside Open Enrollment

After Open Enrollment, you can enroll in private coverage through the Marketplace only if you have a qualifying life event or a complex situation related to applying in the Marketplace. There are a few things you should know about special enrollment periods before you apply. Make sure that you qualify for a special enrollment period.

Qualifying Life Events: Here are some examples of qualifying life events:

  • •Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving your residence, gaining citizenship, leaving incarceration
    •Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
    •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
    •Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.

Lower costs for Marketplace plans: You may be able to get premium tax credits or lower out-of-pocket costs that reduce how much you pay for coverage.

Contact Koehler Koehler, Inc. to get help applying outside the open enrollment period

Medicaid and CHIP: You can also apply for Medicaid and CHIP coverage any time if you think you may qualify.

Fees and Exemptions: Remember, if you don’t have minimum essential coverage, you must either pay a fee or have an exemption from paying the fee.