Understanding the Special Enrollment Period for Health Coverage

by | Mar 23, 2021 | Disability Insurance

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Aside from getting health insurance during the annual open enrollment schedule, states also allow qualified individuals and employers to sign up or upgrade their policies during a special enrollment period (SEP). The SEP can last for 30 days for group plans and up to 60 days for individual policies.

Usually, everyone can purchase or make any changes to their health coverage only during the open enrollment. However, few particular events can trigger a brief window that allows new applications, downgrades, or upgrades for policies.

Qualifying Events for SEP

A significant change in your living situation can make you and your family eligible for the SEP. There are 4 qualifying life events:

  1. Loss of health coverage – An individual can become eligible for the SEP if they or anyone in their household expects to lose or has already lost qualifying health coverage. This includes job-based coverage, student plans, and disqualification from Medicare, Medicaid, and Children’s Health Insurance Program (CHIP).
  2. Changes in the household – Circumstances like getting married or divorced, having a baby or adopting a child, and someone passing away in the family entitles you or your household to SEP.
  3. Changes in residence – A SEP can be granted to those moving from or to a different ZIP code. This can include students who wish to transfer to or from their school’s location, employees relocating for work, and individuals or families transitioning from a shelter to traditional housing.
  4. Other life circumstances – You can also be authorized to enroll during SEP if you have just become a U.S citizen, a member of a federally recognized tribe, left incarceration, or started or left service at AmeriCorps.

The 2021 Special Enrollment Period

President Joe Biden signed an executive order to open a brief enrollment period from February 15 through August 15, 2021, because of the health crisis caused by the coronavirus disease (COVID-19). This schedule lets millions of Americans apply and enroll for the coverage they need during this global pandemic.

This 2021 SEP is the perfect time to get insured with Midwest Employee Benefits, a reliable insurance provider in Sioux Falls, SD. Learn from our licensed agents how to take advantage of this special period to upgrade or apply for the best health coverage.