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Frequently Asked Questions (FAQs)

What sort of "special circumstance" would allow me change my plan during the year or to enroll outside of the open enrollment period?

In general, individuals and families can only enroll in a health plan or change their health plan during the annual open enrollment period. However, certain life changes may qualify you for a special enrollment period. A special enrollment period allows you and your family to enroll in a plan or change plans after open enrollment has ended. You may be eligible for a special enrollment period if you experience one of the following situations:

  • Losing qualifying comprehensive health coverage during the year, as long as you did not voluntarily terminate your health insurance or lose it because you did not pay your premiums
  • Moving to the District of Columbia, as long as you either had qualifying comprehensive health insurance during at least one of the 60 days before you moved to DC, or were living overseas or in a U.S. territory
  • Having a baby, adopting a child, or having a child placed in your home for adoption or foster care
  • Getting married, divorced, or legally separated
  • Entering or leaving a legally-recognized domestic partnership
  • Becoming a citizen or gaining legal immigration status (renewing a visa or changing visa types does not qualify)
  • Being Native American
  • Being court-ordered to get health coverage for yourself or someone else
  • Being released from prison
  • Gaining or losing eligibility for premium tax credits or cost-sharing reductions, or a change in your eligibility for cost-sharing reductions, if you are already enrolled in a DC Health Link plan
  • You were not enrolled in coverage, enrolled in the wrong plan, or your coverage was ended due to an error by a DC Health Link employee, an employee of the U.S. Department of Health and Human Services, someone providing enrollment assistance (for example, an assister or broker), or an insurance company representative
  • You are enrolled in a plan that doesn’t renew at the beginning of the calendar year
  • The insurance company offering your plan through DC Health Link or another health insurance marketplace violated a material provision of the insurance contract as it relates to you
  • An exceptional circumstance as defined by the DC Health Benefit Exchange Authority

Special enrollment periods are time limited. They generally last for 60 days from the date of the event (for example, 60 days after a baby is born). A few special enrollment periods are longer. If you are moving to DC, losing health insurance, or being released from prison, you have 60 days before and after the event (a total of 120 days) to enroll. If you request the special enrollment period too late or too early, you will be denied.

You can see if you qualify for a special enrollment period by logging into your DC Health Link account calling DC Health Link Customer Service at (855) 532-5465.