Getting Coverage Outside of Open Enrollment

Now that the open enrollment deadline has passed (it ended on March 31, 2014), under what circumstances could someone still get health coverage this year?

After Open Enrollment, you can enroll in private coverage through the Marketplace only if you have a qualifying life event or a complex situation related to applying in the Marketplace.

Related Post: ClaimLinx Individual Marketplace Available For Open Enrollment

Qualifying Life events include:

  • Marriage, having a baby, adopting a child or placing a child for adoption or foster care, moving your residence, gaining citizenship, leaving incarceration, and losing your job.
  • Losing other health coverage due to losing your job-based coverage (such as a group plan), divorce, the end of an individual policy plan year in 2014, COBRA expiration, aging off a parent’s plan, losing eligibility for Medicaid or CHIP, and similar circumstances. Important: Voluntarily ending coverage doesn’t qualify you for a special enrollment period. Neither does losing coverage that doesn’t qualify as minimum essential coverage.
  • For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions.
  • Gaining status as member of an Indian tribe. Members of federally recognized Indian tribes can sign up for or change plans once per month throughout the year.

You can enroll in a plan either through the Marketplace or outside the Marketplace if you qualify for a special enrollment period but your income is too high to get lower costs.  Please read more about Qualifying Events here.

Related Post: ClaimLinx Reaches Marketplace Elite Circle of Champions

ClaimLinx is proactively ready for the many changes of Health Care Reform.  For more information please visit the Health Care Reform section on our website.  For a free brochure, please email

If you have additional questions, please feel free to contact us at 513-677-6262; (800) 858-1772 or – we would be happy to help

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