AMJ Health Agency LLC

Special vs Open Enrollment Periods

Understanding when you can enroll in health insurance coverage is crucial for getting the protection you need.

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Open Enrollment Period

When:

November 1 - December 15 annually

Coverage Starts:

January 1 of the following year

Who Can Enroll:

  • Anyone without health insurance
  • People wanting to change plans
  • Those losing employer coverage

Special Enrollment Period

When:

60 days after a qualifying life event

Coverage Starts:

Usually the first day of the next month

Requirements:

Must have a qualifying life event and provide documentation

Qualifying Life Events for Special Enrollment

Changes in Household

  • • Getting married
  • • Having a baby or adopting
  • • Getting divorced
  • • Death of a covered family member

Loss of Coverage

  • • Losing job-based insurance
  • • Aging off parent's plan
  • • COBRA coverage ending
  • • Loss of Medicaid/CHIP

Changes in Location

  • • Moving to a new state
  • • Moving to a new ZIP code
  • • Students moving for school
  • • Gaining access to new plans

Income Changes

  • • Qualifying for premium tax credits
  • • Becoming eligible for Medicaid
  • • Loss of cost-sharing reductions
  • • Changes in subsidy eligibility

Other Qualifying Events

  • • Becoming a U.S. citizen
  • • Release from incarceration
  • • AmeriCorps program changes
  • • Exceptional circumstances

Plan-Related Events

  • • Plan no longer available
  • • Insurer leaving marketplace
  • • Significant plan changes
  • • Error in enrollment

Important Deadlines and Documentation

Key Deadlines

  • 60 days - Time limit to report qualifying event and enroll
  • First of the month - When coverage typically starts
  • 15th of the month - Enrollment deadline for next month coverage

Required Documentation

  • Proof of qualifying life event (marriage certificate, birth certificate, etc.)
  • Termination letter from previous coverage
  • Income verification if applying for subsidies
  • Documentation of date when event occurred
Get Help Understanding Enrollment Periods

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Our experts can help you determine if you qualify for Special Enrollment and guide you through the process.

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