April 24, 2014
Open enrollment is closed, you can enroll in a Covered California health insurance plan only if you experience a qualifying life event. The next open enrollment period will be in the fall of 2014, (October 15th to 12-07). Remember, you can enroll in Medi-Cal at any time during the year.
Here are some examples of qualifying events that can allow you to obtain health insurance coverage outside the open enrollment period.
A. You get married or enter into a domestic partnership.
B. You have or adopt a child, or you place a child in adoption or in a foster home.
C. You change where you permanently live, and you gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
D. You lose your health coverage. For example, you are no longer eligible for Medi-Cal, you lose health coverage through your job, or you have exhausted your COBRA continuation coverage. (Note: Not paying your COBRA premium does not qualify you for special enrollment.)
E. Your income changes so much that you become newly eligible or ineligible for help paying for your insurance. For example, if you are already getting help paying for your insurance premium, and your income goes down, you may be able to get extra help.
F. You become a citizen, national or lawfully present individual. This event applies only to people who were not previously citizens, nationals or lawfully present.
G. If you are a member of a federally recognized American Indian or Alaska Native tribe, you may enroll in health insurance or change your health insurance plan once a month even if the open-enrollment period is over.
H. You applied for health coverage before March 31 and got a denial for Medi-Cal after March 31. If you were incorrectly denied Covered California or Medi-Cal coverage, you can also file an appeal.
I. Your enrollment was wrong, due to the misconduct or misrepresentation of your health insurance company, Covered California or a non-Covered California entity (such as a Certified Enrollment Counselor).
J. Covered California can also determine, on a case-by-case basis, that you experienced an exceptional circumstance, which could allow for a special-enrollment period.
After my qualifying life event, how long do I have to sign up for health insurance or change my health insurance plan in Covered California?
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 your existing Covered California plan. For example, if you have a child on June 1, you have until July 31 to notify Covered California, complete an application for your new child, choose a health plan and pay for it. If you do not get health coverage for your child, you may have to pay a tax penalty.
If 60 days pass and you do not sign up for health coverage, you will have to wait until the next open-enrollment period.
Keep in mind that you can enroll in Medi-Cal at any time. You do not need a special-enrollment period to enroll in Medi-Cal.
How can I enroll if I have a qualifying life event?
Just call us at 858-271-8100 or 888-504-6171 or even shoot us an email at info@comparecarriers.net and we will advise and get the process started. We make the process simple and our services are free. No additional cost to our clients.
Can coverage start right away?
For most qualifying life events, the start date for coverage depends on the date you enroll, as discussed in the question above. If you enroll by the 15th day of the month, your coverage will start on the first day of the next month. If you enroll after the 15th day of the month, you coverage will start on the first day of the second month.
Here are some exceptions for the above stated start dates.
If you lose your coverage thru Medi-Cal, job-based coverage or other coverage, and you use a special-enrollment period, your coverage would start on the first day of the next month following your plan selection, regardless of when during the month you make your plan selection.
If you become married and use a special-enrollment period then coverage will start on the first day of the next month following your plan selection, irrespective of when during the month you make your plan selection.
Covered California can determine on a case by case basis if you may start your coverage earlier.
Please feel free to contact us with any additional questions. We are here to help.
