Qualifying Life Events

 

If you experience a qualifying life event, you can enroll in a Covered California health insurance plan outside of the normal open-enrollment period. Most special enrollment periods last 60 days from the date of the qualifying life event.

Lost job or income
  • You recently lost employment, were laid off, or left your job.
  • Loss of income due to fewer hours or less work.
Lost or will soon lose my health insurance
  • You lose Medi-Cal coverage.
  • You lose your employer-sponsored coverage.
  • Your COBRA coverage is exhausted. Note: Not paying your COBRA premium is not considered loss of coverage.
  • You are no longer eligible for student health coverage.
  • You turn 26 years old and are no longer eligible for a parent’s plan.
  • You turn 19 years old and are no longer eligible for a child-only plan.
Newly qualifies for app-based driver stipend
  • New driver for a ride sharing or delivery company as an independent contractor.
  • Existing driver of a ride sharing or delivery company who expects to drive enough hours to receive the health care stipend.
Got married or entered into domestic partnership
  • One or both members of the new couple can use the special enrollment period to enroll in coverage.
Had a baby, adopted a child, or began fostering a child
  • The entire family can use the special enrollment period to enroll in coverage.
  • If you receive a child in foster care, you will need to indicate “adopted a child” in the drop-down menu when you apply.
Permanently moved to or within California
  • You move to California from out of state.
  • You move within California and gain access to at least one new Covered California health insurance plan.
Gained citizenship/lawful presence
Returned from active-duty military service
  • You have lost coverage after leaving active duty, reserve duty, or the California National Guard.
Domestic abuse or spousal abandonment
Federally recognized American Indian/Alaska Native
  • If you are a member of a federally recognized American Indian tribe, you can enroll at any time and change plans once per month.
Affected by wildfires
  • Exceptional circumstances occurred on or around plan selection deadlines, including natural or human-caused disasters (for example wildfires) and medical emergencies.
Released from jail or prison
 
Other qualifying life event
  • You are already enrolled in a Covered California plan and become newly eligible or ineligible for tax credits or cost-sharing reductions. 
  • You are already enrolled in a Covered California plan and you lose a dependent or lose your status as a dependent due to divorce, legal separation, dissolution of domestic partnership, or death.
  • Misconduct or misinformation occurred during your enrollment, including:
    • An agent, certified enroller, Service Center representative or other authorized representative enrolled you in a plan that you did not want to enroll in, failed to enroll you in any plan or failed to calculate premium assistance for which you were eligible. 
  • Misrepresentation or erroneous enrollment, including:
    • Incorrect eligibility determination. This includes if you applied during open enrollment and were initially told you were eligible for Medi-Cal and then later determined not to be eligible for Medi-Cal.
    • The health plan did not receive your information due to technical issues.
    • An error in processing your verification documents resulted in an incorrect eligibility result.
    • Incorrect plan data were displayed when you selected a plan: Data errors on premiums, benefits or copay/deductibles were displayed; incorrect plans were displayed; or a family could not enroll together in a single plan.
    • Your health plan violated its contract.
  • You received a certificate of exemption for hardship from Health and Human Services for a month or months during the coverage year but lost eligibility for the hardship exemption outside of an open enrollment period.
  • You are required by court order to provide health insurance for a child who was been determined ineligible for Medi-Cal and CHIP, even if you are not the party who expects to claim the child as a tax dependent.
  • You lose “share of cost” Medi-Cal coverage by reaching your share of cost.
  • You are a member of AmeriCorps/VISTA/National Civilian Community Corps: 
    • If you entered AmeriCorps or one of the other organizations listed above outside of open enrollment.
    • If you ended your service with one of the organizations listed above.
  • You have a non-calendar year health plan (including “grandfathered” and “non-grandfathered” health insurance plan) outside of Covered California that has expired or will soon expire, and you would like to switch to a Covered California health insurance plan instead of renewing your current plan.
  • Your provider left the health plan network while you were receiving care for one of the following conditions:
    • Pregnancy
    • Terminal illness
    • An acute condition
    • A serious chronic condition
    • The care of a newborn child between birth and age 36 months
    • A surgery or other procedure that will occur within 180 days of the termination or start date.
None of the above (Continue to review my application for Medi-Cal/Medi-Cal Access Program)

If none of these qualifying life events apply, you should still apply using "None of the above," because you may be eligible for Medi-Cal or the Medi-Cal Access Program (MCAP) for pregnant women based on your income. Regardless of which life event you select, your application will still be reviewed for coverage through Medi-Cal and MCAP.


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