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resource > Health Insurance > Open Enrollment

Qualifying Life Events

Qualifying life events (QLE) are changes in your situation that can make you eligible for enrollment into a health insurance plan outside of the established annual open enrollment period.

QLE recognize that unexpected changes happen, and provide a special enrollment period to obtain health insurance coverage. QLE may differ based on different employers, health insurance providers, or whether you are on Medicaid or a Marketplace health insurance plan.

 

The list below isn't comprehensive– your situation might be considered a QLE, but not be listed here. Talk to your human resources department and/or insurance provider to learn about their specific QLE.

Generally, there are four different types of QLE:


LOSS OF HEALTH COVERAGE

  • Turning 26 years old and losing health insurance coverage through a parent’s plan

  • Losing health insurance coverage that was through a family member

  • Losing existing employer-sponsored, student, or private health insurance coverage

  • Losing eligibility for health insurance coverage through Medicaid, Medicare, or Children’s Health Insurance Program (CHIP)

HOUSEHOLD CHANGES

  • Getting married, divorced, or legally separated

  • Having a baby

  • Adopting or fostering a child

  • Death in the family (especially if the individual who passed was the primary plan-holder)

RESIDENCE CHANGES

  • Moving to a different ZIP code, county, or state within the U.S.

  • Moving to the U.S. from a U.S. territory or a different country

  • Moving to or from the place where one attends college or university (or other schooling)

  • Moving to or from where one lives and works for seasonal employment

  • Moving to or from a housing shelter

OTHER EVENTS

  • Income changes that affect the coverage one qualifies for

  • Becoming a U.S. citizen

  • Starting or ending AmeriCorps service

  • Gaining membership in a federally recognized tribe

  • Gaining status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

 

Note: Documentation may be required to support special enrollment for a qualifying life event. Supporting documentation requirements may differ by situation, type of qualifying life event, or health insurance provider.