Chances are, you’re familiar with open enrollment, the 45-day period you get to select your health plan for the year. But major life changes can happen unexpectedly, and they don’t often fit neatly into those narrow windows. That’s why certain special enrollment periods allow you to make changes to your plan even if open enrollment is long over.
To be eligible, you just need to prove that you’ve experienced one of several qualifying events. Simple, right? Let’s get into exactly how all of this works.
What Are Qualifying Life Events?
A qualifying event is a change in your life that makes you eligible to sign up for health insurance outside of open enrollment. These events typically fall into four different categories:
Loss of health insurance. Did you lose your job and your employer’s health plan along with it? Did you turn 26 and can no longer be covered under your parents’ plan?
Household changes. Did you get married, have a baby or gain a dependent — or get divorced or lose a loved one?
Residency changes. Did you move to a different area or state (or even a different country) for work or school?
Other qualifying life events. Did you become a U.S. citizen or experience income changes that affect what type of health plan you qualify for?
In each of these cases, you may be eligible for special enrollment, but you’ll need documentation to prove you qualify.
What Documentation Do I Need to Prove Qualifying Events?
The documentation you’ll need depends on which qualifying life event applies to you.
Loss of Health Insurance
When you apply for new coverage, the health insurance company will ask for documentation after you submit your application.
If you no longer have health insurance because you lost your job, you’ll have to provide a letter or document from your former employer detailing that your coverage will end on a specified date. You can also get a letter from the insurance company with your coverage termination date or proof that you’ve had health coverage in the last 60 days. If you’ve just turned 26 (happy birthday!) and you can no longer rely on your parents’ coverage, a letter from your previous insurance company is probably the best option.
If you have or adopt a child, or you’re now financially responsible for another dependent for another reason entirely, you qualify for special enrollment. For a new child, you’ll have to provide a birth certificate or adoption record. You also can use a legal guardianship or court order, depending on the person you want to add to your plan.
While less fun to think about, a death in the family also falls into the category of household changes. In this case, your documentation will come in the form of a death certificate from the last 60 days. For a divorce or legal separation, divorce papers will prove that you’re no longer responsible for covering your spouse — or, if you’re the spouse who needs coverage, proof that you had and lost health coverage in the last 60 days will allow you to enroll.
For residency changes, you’re required to prove you had qualifying health care coverage sometime in the last 60 days. On top of that, you’ll need to show proof of residency with documents such as:
Your rental lease agreement or mortgage deed.
A driver’s license or state ID.
Change of address confirmation from the post office.
A letter from your school or your new employer.
A visa, green card or education certificate if you’re coming to the U.S. from another country.
Whether your qualifying life event is because of household changes, residency changes or loss of health care coverage, make sure you have everything you need before you apply for new health insurance. A gap in coverage can be risky, so don’t let the fact that open enrollment has ended stop you from staying protected.