There are a handful of special circumstances and life events that could qualify you for a special enrollment period which begins 60 days before the trigger event lasts 60 days after the trigger event date. The most common “qualifying events” or “trigger events” include:
- You or a dependent lose job-based coverage
- You get married, have a baby, or adopt
- You gain US citizenship
- Your income changes significantly, making you newly eligible (or ineligible) for subsidies
- You permanently move out of state and gain access to new plans
- You are or gain status as a Native American Indian
The reason for this stems from the Affordable Care Act, which mandated that health insurance companies can no longer deny individuals coverage for preexisting conditions. In other words, individuals are guaranteed coverage regardless of their health status.
If individuals could simply start and stop coverage whenever they wanted, many people would simply wait until they got sick or required expensive medical care before buying insurance. That is why the government has limited the time to purchase health insurance to 6 weeks out of the year.