Wednesday, September 10, 2014

Special Enrollment Periods and Life Change Events

From Boulder County AIDS Project's blog, written by Erin Dupuis

Is it possible to buy a marketplace health insurance plan outside of open enrollment? The answer is yes. If you have a qualifying event also known as a Life Change Event you can enroll in or change your health insurance plan. When a change in your life occurs, you have 30 days to report the change and 60 days to shop for insurance. So, what is considered a Life Change Event?



Life Change Events that allow current enrollees to SHOP for a NEW health plan:

  • Change of American Indian/Alaska Native status
  • Change of residence (if moving out of a service area)
  • Gain or loss of eligibility for the tax credit or cost sharing reduction
  • Loss of eligibility for the hardship exemption making you ineligible for your CYA (catastrophic) plan
  • A customer is inadvertently or inappropriately enrolled or not enrolled in a health plan as a result of error, misrepresentation, or inaction by the Marketplace or one of its instrumentalities
  • A customer demonstrates that their health plan has substantially violated a provision of its contract

Life Change Events that allow current enrollees to UPDATE CURRENT plan:
  • Removal of dependent due to divorce/annulment/separation
  • Removal of dependent due to child age out (dependent turns 26)
  • Removal of dependent due to death

Life Change Events that allow new customers to SHOP for a NEW health plan:
  • Marriage or civil union
  • Birth or adoption
  • Loss of minimum essential coverage (MEC)
  • Employer-sponsored coverage becomes unaffordable
  • Gain of Citizenship or Immigration status
  • Change in incarceration status
  • Loss of eligibility for the exemption to purchase health insurance coverage
  • A customer demonstrates that their health plan has substantially violated a provision of its contract
  • Moved to Colorado

Medicaid and CHP+:

You can enroll in Medicaid or the Children’s Health Plan Plus (CHP+) any time. These programs provide health coverage to families with lower incomes. Visit http://colorado.gov/PEAK or talk to your Case Manager to find out if you qualify for Medicaid, CHP+ or a Marketplace plan.

And remember, Colorado ADAP will help pay for specific health insurance plans. Contact us for more information!

In health,
Erin

Source: “Can I Enroll in Coverage after the Annual Open Enrollment Period Has Closed?” Connect for Health Colorado. Connect for Health Colorado, 27 Aug. 2013. Web. 14 Aug. 2014. <https://connectforhealthco.custhelp.com/app/answers/detail/a_id/264>.

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