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Do I need proof of a qualifying life event?
What is a qualifying life event?
Do you need proof of a qualifying event?
What are the qualifying life events for employer-sponsored health insurance?
What is a qualifying event in health insurance?
What is a qualifying life event (QLE) for health insurance?
All on-exchange plans purchased through healthcare.gov require documentation of the qualifying event during the Special Enrollment Period. For off-exchange plans, some insurance companies do not require proof of a qualifying event.
When you experience a qualifying life event, you may be asked for documents to confirm the life event. The type of documentation you need depends on the type of qualifying life event. Talk to your health insurance provider to see what documents are needed for your situation.
- When you experience a major shift in your family life, your benefits may also need to change. Family changes that count as qualifying life events i...
- When it comes to health insurance, turning 26 is a milestone birthday — it’s time for the baby birds to “leave the nest” of their parents’ health i...
- Another change that can affect special enrollment eligibility is moving. It could be that you’re relocating to an area where your current coverage...
- A change in employment status — whether voluntary or involuntary (laid off, dismissed, resigned, quit or retired) — is another qualifying life even...
- If you lose your insurance, it's considered a qualifying life event. This means if you lost your health insurance in the past 60 days (or more than...
- Medicare, a federal program, serves as the primary source of health insurance for those 65 and older (or those under 65 who may qualify for benefit...
- To find out who is eligible for Medicare, what you should do if you choose to work past 65, who can enroll in Original Medicare (Parts A and B) or...
- There are four categories, or parts, of Medicare: Part A: Medicare Part A covers hospital insurance — inpatient hospital stays, care in a skilled n...
Apr 17, 2024 · You may be asked to provide proof of your qualifying life event when you apply for coverage. If so, the Marketplace or insurer will let you know what documentation you need to submit.
- Early ON, Qualifying Events Were on The ‘Honor System’
- Exchanges Now Require Proof of Qualifying Life Events
- Sep Verification Rules Relaxed
But it wasn’t all smooth sailing in the early years after the ACA went into effect. Until 2016, HealthCare.gov didn’t require applicants to prove that they’d experienced a qualifying life event. Applicants had to attest that they had a qualifying life event, but it was basically on the honor system. By late 2015, it had become apparent that healthc...
To address insurer concerns and help stabilize the individual health insurance market, HealthCare.gov’s then-CEO Kevin Counihan noted in January 2016 that the exchange would take steps to enforce the eligibility requirements for SEPs. And by February, the Centers for Medicare & Medicaid Services (CMS) clarified that they would be implementing docum...
Starting in 2023, HealthCare.gov opted to scale back the pre-enrollment verification process for special enrollment periods.8 Loss of coverage is the only qualifying life event that now requires the enrollee to submit proof of the qualifying life event prior to enrollment,9 although that’s the most commonly used qualifying life event.10 In the stat...
May 10, 2024 · You need proof of the qualifying life event to take advantage of special enrollment. If you don't qualify for a special enrollment period, you have to wait until the next open enrollment to get health insurance or change existing health coverage.
- Leslie Kasperowicz
- Managing Editor
- Becoming eligible for Medicare isn’t considered a qualifying life event. However, assuming you have private health insurance coverage, you can drop...
- A spouse getting a new job counts as a qualifying life event because they lose their previous group coverage. In this case, they're able to enroll...
- Yes, divorce is a qualifying life event for health insurance. You would be able to purchase your own individual policy through a SEP. However, you...
- Marriage is one of the most common qualifying events. You typically have 60 days from the date of your legal marriage to purchase health insurance...
Dec 29, 2022 · You must have a qualifying life event to qualify for the special enrollment period. If you have employer-based insurance, you must be granted a special enrollment period of at least 30 days. What...
When you apply for Marketplace coverage and qualify for a Special Enrollment Period due to a life event, you may be asked to send documents to confirm that you qualify. You must send these documents before you can start using your coverage.
