Different changes in your life can impact your access to health insurance. Fortunately, if you experience a qualifying life event, you can access the coverage you need through a Special Enrollment Period (SEP), which can be granted for many reasons. Keep reading to see if your life event qualifies for an SEP.
Open Enrollment vs. Special Enrollment
People choose their health insurance options for the year during their Open Enrollment Period (OEP), which can occur at different times depending on the type of coverage they purchase. For those purchasing an Affordable Care Act (ACA) plan, OEP starts on Nov. 1 and ends Dec. 15 of every year. For those with employer-based coverage, the OEP timeframe will vary by employer.
Life events, like marriage, job changes or bringing a new baby home, can cause you or a dependent on your plan to lose access to creditable health insurance coverage, which is coverage that meets standards set by the government.
When a loss of creditable coverage occurs, you qualify for an SEP, which enables you to purchase coverage outside of an OEP. SEPs typically last 60 days after a qualifying life event. Once a life event occurs, reach out to your health insurance provider and find out what information you need to prove you’re eligible for an SEP.
Qualifying life events
There are many reasons you might qualify for an SEP, from losing your job to moving to a new ZIP code. If you or one of the dependents on your health insurance plan experience any of the following, you could be eligible for an SEP.
Loss of health insurance coverage from:
- Switching jobs.
- Graduating college.
- Losing eligibility for Medicare, Medicaid or CHIP.
- Aging out of your parents’ health insurance at 26 years old.
Changes in your household, including:
- Getting married or divorced.
- Bringing a new child home through birth or adoption.
- Death in the family.
Changes in residence, including:
- Moving to a different ZIP code or county.
- Moving to or from where you attend school as a student.
- Seasonal workers moving to or from their place of work and home.
- Moving to or from a shelter or transitional housing.
Corporation shareholder as in:
- Becoming a U.S. citizen.
- Leaving incarceration.
- AmeriCorps members starting or ending service.
Although 60 days is typical for an SEP, your enrollment period may vary depending on your life event. If you’re unsure if you qualify for an SEP or have questions about the enrollment period, reach out to one of our licensed sales agents to go through your options.
Options BCBSNE offers
BCBSNE has two products available for purchase during an SEP, Nebraska HeartlandBlue and Armor Health. Nebraska HeartlandBlue is BCBSNE’s new 2023 ACA health care plan; individuals can enroll during OEP or throughout the year with a qualifying life event.
If you’re not eligible for an SEP, Armor Health could be a good choice for you. Armor Health is BCBSNE’s individual non-ACA health care plan; individuals can enroll in Armor Health year-round with or without a qualifying life event.
Visit our individual plans page for a comparison of the two product options.
Contact a licensed sales agent
At BCBSNE, we understand life events can happen fast. If you or someone in your household is experiencing a life event that could affect their health insurance, reach out to one of our licensed sales representatives to see which health insurance options could work for you.
For more articles like this, visit Insurance 101.