Health Insurance

Special Enrollment Period Eligibility 2021

To enroll after in coverage after missing the Health Insurance Marketplace, dates, you must qualify for the Special Enrollment Period. There are eligibility requirements you must meet for the Special Enrollment Period (SEP). Whether or not you enroll in coverage through healthcare.gov or your state’s Marketplace, the Special Enrollment Period eligibility requirements is mostly the same. However, we suggest checking the website of your state’s Marketplace. There might be additional ways to qualify for the Special Enrollment Period.

In any given case you lose your health insurance due to an event that is outside of your control, you will qualify for the SEP. For example, if you lost coverage due to the death of someone in your health insurance Marketplace plan, you will qualify.

Generally, there are four main reasons you can lose coverage. These are

  • Death
  • Divorce or Legal Separation
  • Marrying
  • Having a Child

Death

Losing Marketplace coverage due to losing someone in your plan qualifies you for the Special Enrollment Period in 2021. You must pick a plan within thirty days of the event happening though. Your new plan will start automatically on the first day of the next month.

Divorce or Legal Separation

Divorce or legal separation qualifies individuals for the Special Enrollment Period. However, you must lose coverage. If you keep your coverage but divorce, you won’t be eligible for the Special Enrollment Period and keep your existing insurance.

Marrying

If you pick a plan within 60 days of your marriage, your new coverage will begin the first day of the next month. For your Marketplace coverage to start automatically, you must pick a plan by the last day of the month. If you pick a plan in the earlier days of the month, you will have to wait for the next month for your coverage to start.

Having a Child

If you had a child during the year, or adopted a child, or placed a child for the foster care, you will qualify for the Special Enrollment Period. Unlike the other reasons above, you won’t have a time limit. You can enroll in new coverage at any time of the year. However, if you get coverage from other places such as a private health insurer, you won’t be qualifying for the SEP.

As mentioned above, make sure to check your state’s Marketplace website to see other ways you can qualify for the SEP.

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