top of page
Search

What Types of Life Changes Qualify for a Special Enrollment Period?



A Special Enrollment Period (SEP) is a time outside of the regular Open Enrollment Period when you can make changes to your health insurance coverage. This can include things like enrolling in a new plan, changing your plan, or adding or removing dependents.


There are a number of different life events that can qualify you for a SEP. In this article, we'll discuss the most common types of life changes that qualify, as well as some key takeaways to keep in mind.


Types of Life Changes That Qualify for a SEP


The following are some of the most common types of life changes that qualify for a SEP:


Loss of health coverage. This includes losing your job-based health insurance, your student health insurance, or your Medicare or Medicaid coverage.

  • For example, if you lose your job, you may be eligible for a SEP to enroll in a new health insurance plan.

  • You may also be eligible for a SEP if you lose your student health insurance when you graduate from college.

  • And if you lose your Medicare or Medicaid coverage, you may be eligible for a SEP to enroll in a new plan through the health insurance marketplace.

Changes in household. This includes getting married, divorced, or widowed, as well as having a baby or adopting a child.

  • For example, if you get married, you may be able to add your spouse to your health insurance plan.

  • And if you have a baby, you may be eligible for a SEP to enroll in a new plan with better maternity coverage.

  • If you're divorced, you may be able to keep your ex-spouse on your health insurance plan for a certain period of time.

Changes in residence. This includes moving to a new state or ZIP code.

  • For example, if you move to a new state, you may need to change your health insurance plan to one that's offered in that state.

  • And if you move to a new ZIP code, you may be eligible for a SEP to enroll in a new plan with better coverage in your area.

Other qualifying events. This includes certain changes in your income or status, such as becoming unemployed or gaining disability benefits.

  • For example, if you become unemployed, you may be eligible for a SEP to enroll in a new health insurance plan through the health insurance marketplace.

  • And if you gain disability benefits, you may be eligible for a SEP to enroll in a new plan that covers your pre-existing conditions.

Key Takeaway: The most common types of life changes that qualify for a SEP include loss of health coverage, changes in household, changes in residence, and other qualifying events.

How to Get a SEP


If you've experienced a qualifying life event, you can get a SEP by contacting your health insurance company or the health insurance marketplace. You'll need to provide proof of the qualifying event, such as a marriage certificate, a divorce decree, or a letter from your employer stating that you lost your job-based health insurance.


Key Takeaway: To get a SEP, you'll need to contact your health insurance company or the health insurance marketplace and provide proof of the qualifying event.


Examples of How to Use a SEP


Here are some examples of how you might use a SEP:

  • You lose your job and your employer-sponsored health insurance. You use your SEP to enroll in a new health insurance plan through the health insurance marketplace.

  • You get married and want to add your spouse to your health insurance plan. You use your SEP to enroll your spouse in your plan.

  • You move to a new state and your current health insurance plan isn't offered in that state. You use your SEP to enroll in a new plan that's offered in your new state.

  • You become unemployed and gain Medicaid coverage. You use your SEP to enroll in a new health insurance plan that covers your pre-existing conditions.

Key Takeaway: A SEP can give you the opportunity to make changes to your health insurance coverage when you experience a major life change.

Conclusion

If you've experienced a major life change, you may be eligible for a Special Enrollment Period. This can give you the opportunity to make changes to your health insurance coverage, such as enrolling in a new plan, changing your plan, or adding or removing dependents.


To learn more about SEPs, you can contact us anytime. Resolute's personal advisors are at your service at no cost so take advantage of their expertise with your Insurance needs.


8 views0 comments

Comments


bottom of page