Covered California – Special Enrollment Period (SEP)
Get Health Insurance Outside of Open Enrollment If You Have a Qualifying Event
Life can be exciting yet challenging. Not everyone needs health insurance during open enrollment. So what happens when you lose a job and the health benefits that come with it? Moved? Got married or had a baby? The healthcare special enrollment period is for times like these.
Outside open enrollment you can sign up for health insurance with a qualified life event. This is like a valid ticket that allows you or a qualified family member to enroll for an individual or family health plan.
Qualified Life Events
A qualified life event is a circumstance that has occurred within the last 60 days. The 60 days are counted from the date the application is submitted. Some of the most common life events are
Involuntary loss of health insurance
Permanently moved to/within California
Had a baby
A life event is not required for those that are federally recognized American-Indians, Native Alaskans, and those who qualify for Medi-Cal. They can enroll year around.
Special Enrollment Dates
|Year||Open Enrollment Dates||Special Enrollment Dates|
|2017||November 1 – January 31||February 1-October 31|
|2018||November 1 – January 31||February 1-October 31|
|2019 and beyond||November 1 – December 15||December 16- October 31|
The dates for the open enrollment periods were announced by CMS (Centers of Medicare & Medicaid) for the Federal Government’s Health Insurance Exchange. The rest of the year is typically considered the special enrollment period. Covered California has yet to formally announce the dates for California, but historically they have always followed the Federal Government’s lead.
Effective Dates and Deadlines
Whether it’s SEP enrollment or not, most people do n0t want a gap in coverage. Your qualified life event and the date you submit your application determines the effective date.
It is extremely important to know when you need your insurance to start, so you know the deadline to apply by. Usually, you must enroll by the 15th of the month to receive an effective date of the 1st of the next month.
However, if you are losing your coverage, often you can apply by the end of the month and still start your coverage on the 1st of the next month. Although, we recommend not waiting until the last couple days of the month.
What is the difference between the Obamacare special enrollment period and open enrollment?
|Open Enrollment||Special Open Enrollment|
|Who can apply?||Most everyone ( i.e. All U.S. citizens, U.S.
nationals or lawfully present immigrants)
|Only those with a qualified life event|
|When can you apply?||During the open enrollment window of time||Within 60 days of the qualifying life event date|