“Qualifying Life Events” that Allow You to Enroll or Change Your Covered CA Health Plan

Open enrollment for Covered CA ended on March 31st and does not open again until November 15th for a January 1, 2015 start date.

This means that you are “locked-out” of being able to enroll or change your current Covered CA health plan until Jan. 1st.  So what can you do if you need health coverage or want to change health plans now?

The law allows for a “special enrollment” if you or a family member experience a “qualifying life event” or if any of the following circumstances apply to your situation:

1.  You lose your health coverage.  This includes losing health insurance through your job or no longer being eligible for Medi-Cal.

2.  You get married or enter into a domestic partnership

3.  You have or adopt a child

4.  You move

5.  Your non-Covered CA individual health plan is renewing within 60 days.

6.  You become a citizen, national or permanent legal resident

7.  You turn 26 years old and are no longer for coverage under your parent’s plan

8.  Your enrollment was wrong, due to the misconduct or misrepresentation of your health insurance company, Covered CA, a navigator or an insurance agent (anyone who helped you enroll).

9.  Your income changes and you become newly eligible or ineligible for premium assistance or an Enhanced Silver plan.  Review Covered CA Income Guidelines to see if this applies to you.

Covered CA can also determine, on a case-by-case basis, that you experienced an exceptional circumstance, which could allow for a special enrollment period.

Special Enrollment FAQs

How long do I have to sign up for Covered CA?

In most cases you have 60 days before and 60 days after the qualifying life event to apply for a Covered CA health plan.  If you think you have experienced a qualifying life event or are unsure about your situation, complete our online application to see if you qualify for a special enrollment.

How do I enroll if I I have a qualifying life event?

You can complete our online application or call us at 1-800-788-2197 to enroll over the phone.

How do I avoid gaps in coverage?  Can my coverage start right away?

Coverage can start on the first of the next month if you lose health insurance through your job (or Medi-Cal), get married or have a baby.  Other qualifying life events may require to enroll by the 15th of the month for coverage to start on the first day of the next month.  To avoid any gaps in coverage, call us at 1-800-788-2197 to discuss your situation.



AUTHOR - Ali Nagy