What Is a Qualifying Life Event for Health Insurance?

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What are the types of qualifying life events?
1. Household changes in the past 60 days, which may include:
- Getting married.
- Getting divorced or legally separated, but only if this caused you to lose health coverage.
- Giving birth to, adopting or placing a child in foster care.
- The death of someone on your plan, if this causes you to lose coverage.
2. Residential changes, which may include:
- Moving to a new ZIP code or county.
- Moving to or from where you go to school.
- Moving to or from where you live and work, if you work seasonally.
- Moving to or from a shelter or another type of transitional housing.
- Moving to the U.S. from a U.S. territory or foreign country.
3. Loss of health coverage
Individual health coverage
- Your marketplace or other individual plan is discontinued.
- You’re no longer eligible for your plan because you moved outside the plan’s service area.
- You lose eligibility for a student health insurance plan.
- Your household income has gone down, qualifying you for marketplace plan savings.
- Your health plan ends in the middle of the year and you opted not to renew it.
Medicaid or CHIP
- Loss of eligibility for Medicaid or CHIP.
- You applied for these programs during the open enrollment period, but by the time you were denied, open enrollment had ended.
Medicare
Employer reimbursement
4. Other qualifying events
- Income changes that affect your coverage eligibility.
- Becoming a U.S. citizen.
- Becoming a member of a federally recognized tribe or gaining status as an Alaskan Native Claims Settlement Act (ANCSA) Corporation shareholder.
- Beginning or ending service as an AmeriCorps member.
- Being released from incarceration.
- Being the victim of a natural disaster or uncontrollable event such as a flood, hurricane or earthquake.
How can I sign up for coverage if I have a qualifying life event?
- First, check to see if you qualify for a special enrollment period at HealthCare.gov.
- To apply for a marketplace plan, you can create a marketplace account and submit a new application or update your existing application to report a life change. If your state doesn’t use the federal marketplace website, you’ll be directed to your state’s marketplace website to sign up. (Note: If you’ve moved out of state, you’ll need to start a new application, even if you already have an existing one for your former state.)
- You can also create or update a marketplace account 24 hours a day, seven days a week (except holidays) by calling HealthCare.gov at 800-318-2596 (TTY: 855-889-4325). If your state has its own marketplace, you’ll be given the phone number for your state.
- If you’re more comfortable doing this in person, you can find a qualified agent, broker or assister in your area.
What documents might I need to sign up for coverage?
- A letter from your employer on official letterhead that explains that your employer dropped, discontinued contributing to or changed your coverage.
- Written correspondence from the health insurer that shows health coverage cancellation or decertification.
- A letter from your employer or health insurance company that shows your employer’s COBRA coverage offer and start date or the date your COBRA coverage ended or will end.
- Health care program documentation on official letterhead, such as a copy of your military discharge document that includes the date (DD214), a letter from your state Medicaid or CHIP agency stating that your eligibility was denied or will be terminated, or an official letter from a government health program, like Medicare, TRICARE, Peace Corps or Veterans Affairs (VA), stating when your coverage ended or will end.
- A letter on official letterhead that shows you lost student health coverage, including the dates your coverage ended or will end.
- For employer-related changes: Recent pay stubs showing that the deduction for health coverage has ended in the past 60 days or showing a reduction in working hours that caused you to lose health coverage.
- For changes in marital status: Documents showing coverage was lost due to divorce, annulment, legal separation or custody agreements, which may include divorce, annulment or legal separation papers.
- For changes due to death of a family member: A death certificate or public death notice, along with proof that you were getting your health coverage due to your relationship with the deceased, such as an employer or health insurer letter that shows the names of the people on the plan.
How soon will my new health coverage begin after I sign up?
Article sources
- 1. Department of Health and Human Services. Special enrollment opportunities. Accessed Feb 14, 2025.
- 2. Department of Health and Human Services. Special Enrollment Periods. Accessed Feb 14, 2025.
- 3. Department of Health and Human Services. Get or change coverage outside of Open Enrollment. Accessed Feb 14, 2025.
- 4. Department of Health and Human Services. Submit documents to confirm your loss of coverage. Accessed Feb 14, 2025.