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Getting Covered Outside of the Open-Enrollment Period

Open enrollment for 2016 enrollment ended January 31, 2016. For 2017 Open Enrollment will end January 31, 2017. Once open enrollment ends, consumers can enroll in a Covered California health insurance plan only if they have experienced a qualifying life event.

Note:  Consumers can enroll in Medi-Cal at any time.

These are just some of the more common qualifying life events. Consumers can click here to read more about special enrollment and qualifying life events. To apply for coverage through special enrollment, click here.

Signing Up for Health Insurance and/or Changing Health Insurance Plans After a Qualifying Life Event

There is 60 days from the date on which the qualifying life event happens to enroll in a Covered California health insurance plan or change their existing Covered California plan. For instance, if a consumer has a child on June 1, they have until July 31 to notify Covered California, complete an application for their new child, choose a health plan and pay for it. If they do not get health coverage for their child, they may have to pay a tax penalty.

After 60 days passed and consumers did not sign up for health coverage within the 60 days, they will have to wait until the next open enrollment period.

Consumers can enroll in Medi-Cal at any time. There is no special enrollment period to enroll in Medi-Cal.

 

Avoiding Gaps in Coverage

Plan ahead to avoid gaps in your health coverage. Remember, the start date for coverage depends on the date of enrollment. If you enroll by the 15th day of the month, coverage will start on the first day of the next month. If enrolled after the 15th day of the month, coverage will start on the first day of the second month. For example, if consumers enroll on June 13, their coverage will start on July 1. If they enroll on June 16, their coverage will start August 1.

Start Dates for Coverage

For most qualifying life events, the start date for coverage depends on the date that consumers enroll, as discussed in Avoiding Gaps in Coverage. If enrolled by the 15th day of the month, coverage will start on the first day of the next month. If enrolled after the 15th day of the month, coverage will start on the first day of the second month.

But there are a few exceptions to the start date rule:

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Canceled Medi-Cal Coverage and Special Enrollment

Losing Medi-Cal coverage is considered a qualifying event. This would trigger a special enrollment period for consumers. Other qualifying events include the loss of a job, a marriage or divorce, or the birth of a child. In the case of such an event, consumers would be eligible to enroll within 60 days of that event. During that period they cannot be denied coverage by a health plan in Covered California or in the individual market, and would be eligible for the premium assistance that is only available through Covered California.