Qualifying Life Events for Special Enrollment in Health Insurance | Ambetter

   

Big Life Change?

We’re on a mission to make it easier for everyone to get the healthcare coverage they deserve – no matter how life changes.

If you’ve experienced one of these life events in the last 60 days, you may be eligible for a Special Enrollment Period.

   

   

Qualifying Life Events for Special Enrollment

See if you qualify!

  • Employment Change
    You may qualify if you lose health coverage through your employer or the employer of a family member.
  • Loss of Coverage**
    This means you’ve lost healthcare coverage as a result of an individual or marketplace plan being discontinued, loss of eligibility for Medicaid or CHIP, or expiration of COBRA coverage.
  • Aging Out of Parents' Insurance
    If you’ve turned 26 (or the maximum dependent age allowed in your state), you can no longer be on a parent’s health plan.

  • Change in Marital Status
    If you were recently married, pick a plan by the last day of the month and your coverage can start the first day of the next month.
  • New Dependents
    Maybe you’ve had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of that event, even if you enroll in the plan up to 60-days afterward.

  • Change in Residence
    This includes moving to a a new zip code, county or state.*
  • Incarceration Release
    If you’ve left incarceration in the last 60 days, you qualify for Special Enrollment.

  • Change in Citizenship or Immigration Status
    Includes moving to the US from a foreign country or US territory, becoming a citizen or a change in your immigration status.
  • Other Life Changes
    Learn more.

   

   

Your Plan. Your Benefits. 

If you qualify for Special Enrollment, you'll be able to enroll in an affordable Health Insurance plan with access to benefits like Ambetter Telehealth Services+, Prescription Delivery Services, and the My Health Pays®++Rewards Program.

   

 

*In order to qualify, you must also have had minimum essential coverage for one or more days in the 60 days prior to the move, unless you are moving from a foreign country, a United States territory, or you are a member of a federally recognized tribe or a shareholder in an Alaska Native Corporation.

**NOTE: Voluntarily quitting other health coverage or being terminated from health coverage for not paying your premiums are not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.

+$0 cost share applies for in-network telehealth services through Ambetter Telehealth. $0 Ambetter Telehealth cost share does not apply to HSA plans until the deductible is met. Ambetter does not provide medical care. 

++Funds expire immediately upon termination of insurance coverage.