Once the open enrollment period for 2021 is over starting December 16, 2020, You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.
Changes in household
You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days: Got Married, Had a baby, adopted a child, or placed a child for foster care, Got divorced or legally separated and lost health insurance, Died,
Changes in residence
Moving to a new home in a new ZIP code or county, moving to the U.S. from a foreign country or United States territory, If you’re a student, moving to or from the place you attend school, If you’re a seasonal worker, moving to or from the place you both live and work, Moving to or from a shelter or other transitional housing.
Loss of health insurance
You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.
Losing job-based coverage, Losing individual health coverage for a plan or policy you bought yourself, Losing eligibility for Medicaid or CHIP, Losing eligibility for Medicare, Losing coverage through a family member.
An employer offer to help with the cost of coverage
You may qualify for a Special Enrollment Period if you or anyone in your household newly gained access to an individual coverage HRA or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days OR expects to in the next 60 days. If you qualify to enroll in Marketplace coverage through this Special Enrollment Period, call the Marketplace Call Center to complete your enrollment. You can’t do this online.
More qualifying changes
Other life circumstances that may qualify you for a Special Enrollment Period:
Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder, Becoming newly eligible for Marketplace coverage because you became a U.S. citizen, Leaving incarceration, Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member.
What if I’m turned down for a Special Enrollment Period, but I think I qualify?
The Marketplace Appeals Center can review these types of issues:
Not eligible for advance payments of the premium tax credit (APTC)
Eligible for APTC, but the amount is wrong
Not eligible for a Special Enrollment Period
Not eligible to buy a Marketplace plan
Not eligible to choose a Catastrophic plan
Not eligible for an exemption from the requirement to have health insurance