Special Enrollment Periods

Posted: January 20, 2015


There are two types of enrollment periods, Open Enrollment and Special Enrollment. Open enrollment is limited to a few months each year.  Open enrollment begins November 15 and runs through February 15, with three possible effective dates of January 1, February 1 and March 1, with guarantee acceptance. There are no health screen or pre-existing condition requirements.

During the rest of the year individuals may qualify for a Special Enrollment Period. To be eligible for a Special Enrollment Period there must be a qualifying event.  Below is a non-inclusive list of qualifying events:

  • Having a baby; adopting a child or placing a child for adoption or foster care.
  • Getting married.
  • Loss of other health coverage, this can happen for many reasons:
    • Loss of employer group coverage.
    • End of COBRA coverage.
    • Age off a parent’s coverage at age 26.
    • Divorce
    • Loss of Medical Assistance or MinnesotaCare.
    • Loss of government-sponsored coverage such as CHAMPUS and TRICARE.
  • Being denied Medicaid or CHIP coverage.
  • Move residence outside current insurance plan service area.
  • Gaining citizenship.
  • Gaining status as member of a federally recognized tribe.
  • Leaving incarceration.
  • For individuals already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions.

Under these circumstances individuals will need to provide proof of the qualifying event.

More information can be found about MNSure’s Special Enrollment periods here.

Also available is Short-Term coverage, which individuals can purchase 30, 60 or 90 day plans.  Enrollment for short term coverage runs all year, and does not require a qualifying event; this coverage can be re-applied for at the end of coverage period.  This type of coverage does not meet Affordable Care Act requirements; therefore individuals opting for this may be subject to a tax penalty.



Linda Presler

For more information on articles such as this, contact Linda Presler at 952-373-1801.

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