Outside of the yearly Open Enrollment Period, in order to sign up for health insurance, you must experience a qualifying life event; that is the Special Enrollment Period. Currently, enrolled members who experience a qualifying life event can change their coverage or choose a new plan.
Even if you only need coverage for a few months, look to Collective:Choice throughout the year for your health insurance needs.
You recently lost or will soon lose your coverage
You lose Medi-Cal coverage.
You lose your employer-sponsored coverage.
Your COBRA coverage is exhausted. (Note: Not paying your COBRA premium is not considered loss of coverage.)
You are no longer eligible for student health coverage.
You turn 26 years old and are no longer eligible for a parent’s plan. (You can stay on a parent’s plan until coverage ends on Dec. 31, even if you turn 26 mid-year.)
You turn 19 years old and are no longer eligible for a child-only plan.
You recently moved to or within California
You move to California from out of state.
You move within California and gain access to at least one new Covered California health insurance plan.This category also applies to individuals who are released from jail or prison.
You recently got married or entered into a domestic partnership.
One or both members of the new couple can use the special-enrollment period to enroll in coverage.
Had a Baby
A child is born, adopted or received into foster care.
The entire family can use the special-enrollment period to enroll in coverage.
These are just some of the more common qualifying life events. Covered California can also determine, on a case-by-case basis, that you experienced an exceptional circumstance that could allow for a special-enrollment period. To see if you’re eligible, contact us today at (800) 650-0922 or visit one of our office locations.
Deadlines to Enroll After a Qualifying Life Event
You have 60 days from the date on which the qualifying life event happens to enroll in a Covered California health insurance plan or change their existing plan.
If 60 days pass and you do not sign up for health coverage, you will have to wait until the next open-enrollment period.
How to Enroll After a Qualifying Life Event
For many qualifying life events, you can enroll by giving us a call at (800) 650-0922 or by visiting one of our locations in the Los Angeles and Orange County area.
Start Dates and Avoiding Gaps in Coverage
You will need to plan ahead to avoid gaps in health coverage. In general, the start date for coverage depends on the date of enrollment. If you enroll by the 15th day of the month, coverage will start on the first day of the next month. If you enroll after the 15th day of the month, coverage will start on the first day of the second month.
If you enroll on April 10, coverage will start on May 1.
If you enroll on April 16, coverage will start June 1.
There are a few exceptions to the regular start-date rule:
For a loss of health coverage, such as losing Medi-Cal or job-based coverage, the new health plan would start on the first day of the next month following plan selection.
If you get married and apply during the special-enrollment period, your new health plan would start on the first day of the next month following plan selection.
If you have a child, adopt a child or place a child in adoption or foster care, and you use a special-enrollment period, you can choose to have coverage will start on the date of the birth, the adoption or the placement for adoption or foster care, or on the first day of the next month following plan selection.
Documents to Verify a Qualifying Life Event
Some consumers who apply for Covered California coverage in a special-enrollment period are asked to submit verification of their qualifying life event. If you receive a letter asking you to submit documents for your qualifying life event, check the Special Enrollment Acceptable Document List to select the right document to send to us.