Q. I’m graduating from college in a couple of weeks and my student health coverage will terminate at the end of August. Can I sign up for a new health plan then or do I have to wait until the next open enrollment?
A. You don’t have to wait. There are plenty of legitimate reasons why someone might lose or become newly eligible for health coverage in between open enrollment, which is why the new health care law sets up Special Enrollment Periods for people in these circumstances.
The most common circumstance is losing other health coverage. Examples of how this can happen:
- You graduate and your student health insurance runs out.
- Your COBRA coverage comes to an end.
- You leave a job (laid off, quit, or retired, doesn’t matter) and lose your group plan.
- Your old individual insurance policy, purchased before 2014, runs out.
- You turn 26 and get kicked off your parent’s plan.
- You move away from your health plan’s service area.
- Your income goes up and you are no longer eligible for Medicaid or CHIP.
- You lose access to your spouse's employer group plan through divorce or death.
Special Enrollment Periods are also available if you or someone in your family becomes newly eligible for coverage. How this can happen:
- You have a baby.
- You become a “lawfully present” resident of the U.S.
- You get married.
- You get out of jail.
- You return permanently to the U.S. after living abroad.
To activate a Special Enrollment Period, log into your marketplace account, or create a new one, and start an application. Here are Healthcare.gov’s instructions on how to complete the process.
So does this mean if you don’t like the coverage you have now, you can cancel it and get a Special Enrollment Period to get something else? No, it doesn’t.
Also, as we’ve noted many times before, getting sick or injured and suddenly needing costly medical care does not entitle you to a Special Enrollment Period.
In both of these situations, you’ll have to wait until the next open enrollment period to switch or pick up coverage. It runs from Nov. 15, 2014, through Feb. 15, 2015. The earliest coverage can start is Jan. 1, 2015.
Got a question for our health insurance expert? Ask it here; be sure to include the state you live in. And if you can't get enough health insurance news here, follow me on Twitter @NancyMetcalf.
—Nancy Metcalf
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