Special Enrollment Periods

Individuals and families can enroll in a private health plan after January 31, 2016 if they have had a Qualifying Life Event.

Qualifying Life Events Eligible for a Special Enrollment Period:

  • Loss of minimum essential coverage
  • Marriage or domestic partnership, birth, adoption, or placement in foster care
  • Becoming a citizen, national, or lawfully present individual
  • For those already enrolled in a QHP, becoming newly eligible or ineligible for tax credits; or eligible for a different amount of cost sharing reductions
  • Permanent move to NY, or permanent move from one county to another within NY
  • Marketplace staff or contractor enrollment error
  • Assistor misconduct
  • Qualified Health Plan violated a provision of its contract
  • American Indians can enroll or change plans one time per month throughout the year
  • Other exceptional circumstances, as defined by HHS.

Not considered a Qualifying Life Event:

  • Voluntarily dropping other health coverage
  • Being terminated for not paying your premiums
  • Losing coverage that is not minimum essential coverage, in accordance with HHS guidelines

Call our Customer Support Center at (855) 355-5777 for more information and help applying.

Important Information Before You Apply

Children can apply for coverage any time during the year. Low-income adults who may be eligible for Medicaid or the Essential Plan can also apply at any time during the year. (Visit here to see if you are eligible.)

Other individuals and families can apply for coverage in a Qualified Health Plan only during Open Enrollment Period which begins November 1 every year, unless they have a life event, such as loss of coverage, marriage or birth of a child, that qualifies them for a Special Enrollment Period. Individuals must apply within 60 days of the Qualifying Life Event.

Continue

Important Information Before You Apply

Children can apply for coverage any time during the year. Low-income adults who may be eligible for Medicaid or the Essential Plan can also apply at any time during the year. (Visit here to see if you are eligible.)

Other individuals and families can apply for coverage in a Qualified Health Plan only during Open Enrollment Period which begins November 1 every year, unless they have a life event, such as loss of coverage, marriage or birth of a child, that qualifies them for a Special Enrollment Period. Individuals must apply within 60 days of the Qualifying Life Event.

Continue