Here’s how to understand the enroll-by deadlines — and navigate your options if you experience a sudden life change.
If you’ve ever shopped for health insurance, you may have heard of the term “open enrollment.” This refers to the period of time each year — usually a few months during the fall and winter — when you can buy health insurance or change your health plan.
In most circumstances, you have to wait until open enrollment to buy a new health plan or change an existing one — and for good reason. Restrictive timing keeps the cost of health insurance under control for everyone by preventing individuals from enrolling only when they are sick or injured. You can’t wait and get homeowners insurance after your basement floods; the same rules apply for health insurance.
If you miss the enroll-by date, you might have to wait until the next open enrollment period — but there are some exceptions. If you go through a major life change, you may still be able to apply for health insurance with Covered California under special enrollment. A special enrollment window is triggered when you experience a qualifying life event — like losing your current health insurance, getting married, or having a baby — and for most qualifying life events, you have 60 days after the date of that event to enroll.
Common Ways to Qualify for Special Enrollment
Lost Coverage: Losing your job and your employer-sponsored coverage, becoming ineligible for Medi-Cal or student health coverage, exhausting your COBRA or even aging out of your parent’s health plan can all qualify you for special enrollment.
Moved: You will qualify for special enrollment if you have relocated to California from out of state. Some health plans available through Covered California are regionally specific, so if you have moved within the state and now have access to new plans, you also qualify.
Just Married: If you’ve gotten married or entered into a domestic partnership, one or both members can enroll.
New Child: The birth or adoption of a child, or receiving a child through foster care, can trigger special enrollment for the entire family.
A more comprehensive list of qualifying life events also includes returning from active duty military service or gaining citizenship or permanent legal residency. While a serious chronic condition, terminal illness, or pregnancy itself is not considered a qualifying life event, your provider leaving your health plan network in the middle of your care can trigger a special enrollment. Other unique options are also available for pregnant women who find themselves without insurance, including Medi-Cal, which enrolls qualified members at any time.
Deadlines Still Apply
Remember: If you qualify for special enrollment, it’s important to take action and enroll for coverage as soon as possible. For most qualifying life events, you only have 60 days from the date of your event to enroll in a Covered California health insurance plan or change your existing plan. Stay covered in 2020 to protect your health, safeguard your finances and avoid the California penalty that comes from going uninsured.