Qualifying Life Events That Allow You to Buy Health Insurance

News Flash: The health insurance landscape has changed.

Individuals who once could buy health insurance whenever they wanted are now forced to act like traditional company employees, and only enroll in a health insurance plan during an annual open enrollment period. However, life can throw curve balls, and leave an individual without health insurance outside of the open enrollment period. Then what?

The structure of the Affordable Care Act doesn’t leave these individuals without coverage. Anyone with qualifying life events can enroll in a healthcare plan outside of the open enrollment period. This special life circumstances include:

  • Losing your employer insurance coverage
  • Having COBRA coverage expire
  • Getting married
  • Getting divorced
  • Having a baby (or adopting a child)
  • Moving to a new ZIP code
  • Turing 26 and losing coverage through a parent’s plan
  • Gaining U.S. citizenship
  • Leaving incarceration
  • Losing Medicaid or CHIP status
  • Being discharged from the Armed Forces
  • Gaining status as a member of a Native American tribe or Alaskan native

It is critical to know that you must enroll in an individual plan within 60 days of losing coverage. If you fail to meet the deadline, you will not be allowed to purchase health insurance and could suffer paying a fine for failing to comply with the Affordable Care Act mandate that states all Americans must have health insurance coverage for a minimum of nine months of the year. The fine would be paid along with any federal taxes you might owe. If you typically receive a refund, the total amount of the fine will be withheld from your refund dollars.

For illustrative purposes, let’s look at a family of four, with two adults and two children. The mother decides to leave her job and move the family back to her home state so she can assist her parents in their senior years. The mother carried health insurance coverage for the entire family through her employer. When she leaves her job, she decides to sign up for COBRA coverage so no one is left uninsured. However, COBRA coverage is expensive and is immediately a strain on family savings as they look for new jobs and try to buy a home. In this instance, the family of four is eligible to apply for health insurance for two reasons:

  1. They have lost health insurance coverage
  2. They are moving to a new ZIP code

Anytime you have a major life event and find yourself without health insurance, remember to investigate health insurance through your state exchange, the federal marketplace, or through a website entity like HealthCare.org to get covered.