See below.
Q What if a person’s situation changes
and he needs health care coverage? Can he go to the Marketplace outside of the
open enrollment period?
A If a person loses his job or has another qualifying life event, he may
qualify for a special enrollment period on the Marketplace. A person will
qualify if:
- He loses minimum essential coverage, including through divorce.
- He gains a dependent or becomes a dependent through marriage, birth, adoption or placement for adoption or foster care.
- He becomes a citizen, national or lawfully present individual.
- He is eligible to enroll but didn’t because of a mistake, misrepresentation or inaction of an officer, employee or agent of the Marketplace.
- The plan he enrolled in substantially violated a material provision of its contract with the individual.
- He becomes newly eligible for premium tax credits or cost-sharing assistance.
- He becomes ineligible for premium tax credits or cost-sharing assistance.
- He makes a permanent move and has access to new health plans.
- He is a member of an American Indian tribe (American Indians can enroll in a plan or change plans one time each month).
- He demonstrates to the Marketplace that he has other extenuating circumstances that qualify him for special enrollment.
- When any of these situations happen, he will have 60 days to go to the Marketplace to enroll in a health insurance plan or change plans.
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