If you have a life change - also called a qualifying life event - you may be able to get health insurance coverage in the Individual & Family marketplace outside of the annual open enrollment period or make changes to your plan during the year if you act within 60 days of the event. This is called a special enrollment period. If you get your insurance through your employer, the rules are different, you only have 30 days and you should review Qualifying Life Events for Employer-Sponsored Insurance.
Common Qualifying Life Events in the Individual & Family Marketplace Include:
- Lost or will soon lose comprehensive health coverage
- Getting married or entering into a legal domestic partnership
- Change in family size (birth, adoption, foster child)
- Getting a divorce, legally separating or terminating a legal domestic partnership
- New District resident
- Gaining citizenship or a lawful presence in the US
- Release from incarceration (jail or prison)
Remember - you must report these events within 60 days.
If you currently receive financial assistance such as Medicaid, tax credits or cost-sharing reductions, you should report changes in income along with any life events immediately.
- If your income increases or you lose a member of your household, you may qualify for less assistance. If you don't report these changes, you may have to pay money back when you file your federal tax return.
- If your income decreases or you gain a member of your household, you may qualify for additional savings that can lower your costs even more.
If you're a member of a federally recognized tribe or an Alaskan Native Claims Settlement Act (ANCSA) Corporation shareholder, you're eligible for enhanced benefits and protections.
- You can enroll anytime during the year.
- You're also eligible for additional savings when you apply for assistance.
These are only some of the reasons you may qualify for a special enrollment period. To report changes or to see if you qualify for a special enrollment period, login to your account at dchealthlink.com or call us at (855) 532-5465.