You or a family member may qualify for the SEP if you:

• Married recently
• Had a baby
• Adopted a child
• Placed a child for adoption or foster care
• Moved outside your plan’s coverage area
• Gained citizenship or residence in the United States
• Recently turned 26 and lost your parent’s health insurance
• Got out of prison
• Got a divorce and lost your spouse’s insurance
• Are a member of an Indian tribe or are an Alaska Native shareholder

Likewise, if you’re already enrolled through the Marketplace coverage, you can sign up for a new plan if there has been a change in income or household status that affects eligibility for tax credits or cost-sharing reductions. You will also be able to enroll in health care coverage if someone from your household meets the conditions.

Go ahead and apply online or by phone if you or a family member qualifies!

If you’d like to apply by phone, make sure to use this checklist as a guide to make the process go by smoother when you call the Marketplace Call Center at 1-800-318-2596. The representative on the phone will let you know if you qualify or not. If you feel that you do and are told you don’t, you can appeal the decision.

You may also enroll through Medicaid or the Children’s Health Insurance Program (CHIP), which provides no or low cost health coverage. If you qualify through either of these two programs, you can enroll right away. Small businesses are affected as well because they have to apply for Small Business Health Options Program (SHOP) coverage for their employees.

Still having trouble figuring out whether or not you qualify for this special enrollment? Check here.

So don’t get stuck paying another fee! If you still do not have health coverage for this year, you’ll have to pay an even higher penalty fee. If you missed the Open Enrollment deadline and don’t qualify for the SEP, you can get coverage by purchasing a Marketplace health plan starting November 1, 2015, through January 31, 2016.

The National Women’s Health Network is a great supporter for expanding health care coverage to everyone across diverse communities, especially women. It’s important to have health care coverage because the ultimate goal is to cover everyone, lower the increase of costs, and make sure everyone is healthy.

Make sure to get covered and stay covered!

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Prisca Maldonado was a NWHN Intern in Spring 2015.

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The continued availability of external resources is outside of the NWHN’s control. If the link you are looking for is broken, contact us at [email protected] to request more current citation information.

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Additional Resources:

https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/