Affordable Care Act
Qualifying Life Events under Obamacare
Updated on November 15, 2019
The Affordable Care Act (ACA or “Obamacare”) allows you and your family to sign up for health insurance outside of Obamacare’s open enrollment period if you experience certain qualifying life events.
Such qualifying life events include marriage, childbirth, and other major happenings. In most cases, you have 60 days after the date that triggered the qualifying life event to purchase major medical individual or family health insurance coverage. This 60-day period is sometimes referred to as you special enrollment period.
What are qualifying life events?
Qualifying life events that allow you to register for health insurance outside of open enrollment include, but are not limited to, the following:
- Loss of essential health coverage: If you or one of your dependents lose health coverage that meets minimum government standards.
- Change of family structure: If you gain a dependent or become a dependent because of a marriage, death in the family, or birth or adoption of a child.
- Change in citizenship status: If you become a U.S. citizen, national, or gain lawful status in the United States.
- Government error: If you lose, change, or enroll in coverage because of an error committed by an officer, employee, or agent of the Exchange or the Department of Health and Human Services.
- Change in subsidy eligibility: If you are determined newly eligible or newly ineligible for Obamacare subsidies.
- Move to a new coverage area: If you permanently move to a new area and gain access to new Qualified Health Plans.
Top Qualifying Life Events Reported by eHealth Customers
A June 2014 analysis of eHealth shoppers identified the following as the top qualifying life events reported by customers:
|Loss of health coverage||49%|
|Marriage or divorce||6%|
|Birth or adoption of a child||3%|
Experiencing any of the qualifying life events listed above may allow you to purchase health insurance coverage on your own outside of open enrollment.
If you experience a qualifying life event, you can compare options and enroll in coverage through a licensed online health insurance agent like eHealth.