Open Enrollment and Special Enrollment

Covered California has said they will allow extended enrollment through 2/22/15 for certain scenarios.

To take advantage of the extra time, they must have been, and be, working with a certified insurance agent, enrollment counselor or county eligibility worker.

After this Open Enrollment window closes, only Qualifying Events (or Special Enrollment Periods) allow consumers to change plans or enroll in a new plan.

EXAMPLE OF QUALIFYING LIFE EVENTS FOR SPECIAL ENROLLMENT:

  • Getting married or entering into a domestic partnership.
  • Having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
  • Change in place of residency, which allows a consumer to gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
  • Losing health coverage. For example, consumers are no longer eligible for Medi-Cal, or they lose health coverage through their job.
  • Income changes so much that a consumer becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help.
  • Becoming citizens, national or lawfully present individuals. This event applies only to people who were not previously citizens, nationals or lawfully present.
  • The consumer’s enrollment was wrong, due to the misconduct or misrepresentation of their health insurance company, Covered California or a non-Covered California entity (such as a Certified Enrollment Counselor).
  • Being a member of a federally recognized American Indian or Alaska Native tribe. A consumer in this category may enroll in health insurance or change health insurance plan once a month even if the open enrollment period is over.
  • Covered California can also determine, on a case-by-case basis, that the consumer experienced an exceptional circumstance, which could allow for a special enrollment period.

Eligible consumers with a low income, who qualify, can apply for Medi-Cal anytime throughout the year.

For more information, you can view the Covered California link below.  To enroll in a plan and explore your options, contact Steve Downey, or any Covered California Certified Insurance Agent.

http://www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/

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