The Affordable Care Act guarantees that almost everyone can get health insurance. In most cases, you can only sign up for a health insurance plan during the open enrollment period.
If you miss open enrollment, you may be able to enroll during the special enrollment period. This runs from February 1, 2016 through October 31, 2016. To be eligible, you must have had a qualifying "life event" within the past 60 days.
What Is a Qualifying Life Event?
You have had a qualifying life event — and therefore qualify for the special enrollment period — if:
- You move to a new area that offers you different plans, or isn't covered by your HMO network.
- You get married.
- You have or adopt a child.
- You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.*
- You become a U.S. citizen.
- Your income changes, or some other event changes your income or household status.
- You can prove that your health insurance company violated its contract with you.
- You are no longer covered on a family member's policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.
- You become a member of an American Indian and Alaska Native tribe.
- You experience an error or other complication when trying to enroll
How Does Special Enrollment Work?
In most cases, you have 60 days after the qualifying life event to enroll in or change your health plan. If you have insurance through your job, you may only have 30 days to enroll. You can enroll directly through Blue Cross and Blue Shield of New Mexico (BCBSNM). Or, if you think you qualify for financial assistance, you can apply on the Health Insurance Exchange.
If you already have a plan and want to change it, you can do so on the Exchange or with BCBSNM, depending on where you first enrolled.
When you sign up for or change your insurance plan during the special enrollment period, your coverage may not start right away. The date your coverage starts is based on your life event and the date you apply.
What Documents Do I Need for Special Enrollment?
To enroll in health care coverage during special enrollment, you'll need to show documents with the date of the life event. The documents you will need may vary from a government issued ID to an employer letter on company letterhead.
What if I Don’t Qualify for Special Enrollment?
Depending on your income, you may qualify for Medicaid or CHIP. There is no special enrollment period for those government offered coverage options — you can apply at any time.
* Please note that the following are not considered loss of coverage: voluntarily canceling your health insurance plan, having your plan canceled because you did not pay your premiums or because your plan did not meet the requirements set by the Affordable Care Act.