Special Enrollment Period (SEP) - Health Insurance

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What is a Special Enrollment Period (SEP) in Health Insurance?

<lingo>The special enrollment period (SEP) for health insurance is the period during which a qualifying life event makes you eligible to get insurance. Normally there is only one enrollment period for the year, and if you miss that period you must wait until the next year to enroll. But certain life events, such as marriage, a new baby, a move, an adoption, or a loss of health care coverage can make you eligible to enroll in a health insurance plan during any time of the year.</lingo>

Special Enrollment Period (SEP) Clearly and Briefly Explained

Normally, the open enrollment period for a health insurance plan is at the end of the year. If you miss that enrollment period, you'll have to wait until the end of the following year before you can enroll. With a special enrollment period (SEP), though, you avoid that problem. For example, say you get married in March and you want to add your spouse to your insurance plan. You can do that, because marriage is a qualifying life event that triggers the SEP. You may be asked to provide proof, such as your marriage license, and you generally have 60 days after the event has occurred to enroll.

 

<twitter>The special enrollment period (SEP) for health insurance is the period during which a qualifying life event makes you eligible to get insurance.</twitter>

 

 

You don't want to miss that SEP window, or you'll need to wait until the next open enrollment period. Fortunately, it's usually pretty easy to get coverage during an SEP as long as you have a qualifying life event that you can prove. Keep in mind that getting a divorce doesn't count as a qualifying life event, so you may not be able to get coverage if that happens. However, if you're dropped off of your spouse's coverage or move to another area of the country because of the divorce, that may qualify you for an SEP.

 

Being removed from your spouse's healthcare plan would qualify as losing your coverage, which is a qualifying event. Moving is a qualifying event, as well, and if your income is low and you qualify for Medicaid or the Children's Health Insurance Plan (CHIP), you don't need an SEP to enroll. You can enroll in one of those plans at any time throughout the year, without the need for a qualifying life event.

 

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