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Question: What are considered qualifying events for individuals to buy coverage from the Marketplace outside of the annual enrollment period?

Answer: According to the Healthcare.gov website, individuals may purchase Marketplace health insurance plans outside of the open enrollment period as long as there is a qualifying event.  The site lists the following as qualifying life events that trigger the special enrollment period as follows:

  • Marriage
  • Birth, adoption or placement of a child in the household
  • Permanently moving to a new area that offers different health plan options
  • Losing other health coverage due to a job loss, divorce, loss of eligibility for Medicaid or CHIP, expiration of COBRA coverage, or a health plan being decertified

Voluntarily quitting other health coverage, losing coverage or not paying premiums or losing coverage that does not meet ACA’s minimum essential coverage requirements is not considered loss of coverage that would create a special enrollment period.

According to the Healthcare.gov site, most special enrollment periods last 60 days from the date of the qualifying life event.  Please note that the open enrollment for Marketplace coverage ends March 31, 2014. The next proposed open enrollment period is November 15, 2014 – January 15, 2015.