06/03/2015
Great information from Covered California.
Special Enrollment
Getting Covered Outside of the Open-Enrollment Period
Open enrollment for 2015 coverage ended Feb. 15. Once open enrollment has ended, consumers can enroll in a Covered California health insurance plan only if they have experienced a qualifying life event. Consumers can enroll in Medi-Cal at any time.
Below is a list of common types of qualifying life events for special enrollment that apply year-round.
•Losing health coverage. For example, consumers are no longer eligible for Medi-Cal, or they lose health coverage through their job.
•Income changes so much that a consumer becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help.
•Turning 26 years old and are no longer eligible to stay on your parents’ plan.
•Change in place of residency, which allows a consumer to gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
•Having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
•Getting married or entering into a domestic partnership.
•Becoming citizens, national or lawfully present individuals. This event applies only to people who were not previously citizens, nationals or lawfully present.
•Being a member of a federally recognized American Indian or Alaska Native tribe. A consumer in this category may enroll in health insurance or change health insurance plan once a month even if the open enrollment period is over.
•Covered California can also determine, on a case-by-case basis, that the consumer experienced an exceptional circumstance, which could allow for a special enrollment period.
These are just some of the more common qualifying life events. Consumers can click here to read more about special enrollment and qualifying life events. To apply for coverage through special enrollment, click here.
Signing Up for Health Insurance or Changing Health Insurance Plans After a Qualifying Life Event
Consumers have 60 days from the date on which the qualifying life event happens to enroll in a Covered California health insurance plan or change their existing Covered California plan. For example, if a consumer has a child on June 1, they have until July 31 to notify Covered California, complete an application for their new child, choose a health plan and pay for it. If they do not get health coverage for their child, they may have to pay a tax penalty.
If 60 days pass and consumers do not sign up for health coverage, they will have to wait until the next open enrollment period.
