What is a "qualifying event" for Obamacare?





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Published on Apr 9, 2014

At eHealth we're often asked, "Do I qualify for Obamacare?"

Under the Affordable Care Act—Obamacare--if you want to enroll in a health plan outside of the annual Open Enrollment Period, you must have what's called a qualifying event -- which is sometimes also referred to as a qualifying life event

An example of a qualifying event would be:
1. Permanently moving to a new city or state
2. Certain changes in your income
3. Changes in your family due to marriage, divorce, birth of a child, or loss of a loved-one
4. Loss of existing health coverage because of a job change or job loss
5. Loss of eligibility for Medicaid or CHIP,
6. Or, expiration of your COBRA benefits

If you have a qualifying event, in most cases that triggers a 60-day Special Enrollment Period when you can change your existing coverage or apply for a new plan.

If you have a qualifying event that triggers a special enrollment period, eHealth recommends that you have documentation of your qualifying life event with you when you apply for new coverage -- whether you apply online or offline.

In some instances, documentation forms may not be necessary, but it's better to have them in case your new insurance company needs them.

You should also be aware that you're not likely to qualify for a Special Enrollment Period if you voluntarily cancel your coverage or lose it because you didn't pay your bills.
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