What if my life changes? Can I get health insurance coverage in the Marketplace?
Life events may qualify you for different Marketplace health insurance coverage or savings.
Open Enrollment for 2014 coverage has ended in the Marketplace. However, you might still be able to enroll in private coverage through the Marketplace if you have a qualifying life event or a complex situation related to applying in the Marketplace. If you do, you get a special enrollment period allowing you to buy a health insurance plan through the Marketplace.
It is important to note there is no limited enrollment period for certain groups or plans. Members of federally-recognized tribes and Alaska Native shareholders can enroll in Marketplace coverage any time of year, and they can change plans as often as once a month. Enrollment is also ongoing in Michigan for Medicaid, the Healthy Michigan Plan, and MiChild if you think you qualify.
Examples of qualifying life events for Marketplace plans are:
- Having a baby
- Adopting a child or placing a child for adoption or foster care
- Moving outside your insurer’s coverage area
- Losing other health coverage—due to losing job-based coverage, divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or MiChild and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
- Gaining citizenship
- Leaving incarceration
- Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.
- For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
When you enroll in a Marketplace plan during a special enrollment period, you may be able to get premium tax credits or lower out-of-pocket costs that reduce how much you pay for coverage. This will depend on your household size and income. If you qualify for a special enrollment period but your income is too high to get lower costs, you can enroll in a plan either through the Marketplace or outside the Marketplace. Learn more about your options for buying a plan if you don’t qualify for lower costs.
If you do not appear to qualify for a special enrollment period, or if you apply and the Marketplace says that you do not qualify, you have the following options:
- You can appeal a decision to deny you a special enrollment period.
- You can apply for Medicaid, the Healthy Michigan Plan or MiChild coverage if you think you may qualify.
For more information or assistance, visit HealthCare.gov, or call the Health Insurance Marketplace call center at 1-800‑318-2596. TTY users should call 1-855-889-4325. You can find local application assisters at localhelp.healthcare.gov or Enroll Michigan or some private insurance companies with plans in the Marketplace.
For more answers to your questions about health insurance, go to healthcare.gov Q&A or the Health Insurance FAQs - eXtension. Also, Michigan State University Extension is providing education about health insurance basics this year, including the why, what and how for making a smart decision. Find out about Smart Choice: Health Insurance workshops and factual information at the Affordable Care Act Roadmap.