Special Enrollment for Purchasing a Plan Through Covered California

The open enrollment is now over but you can still purchase health insurance through Covered California if you have had a life changing events such as: relocation, birth, marriage, changing your immigration status, being dropped from your current coverage, etc.

You must enroll into a health plan within 60 days of your life changing event. However, if you are about to lose your health coverage you can also purchase a health plan on the final month of your expiring health plan.

Give us a call 800-900-8850 today to get help on your special enrollment.

Review the chart below to confirm if your life changing event qualifies you for special enrollment.

Chart Source: Covered California


Qualifying Life Event:


Lost or will soon lose my health insurance 
Examples:

  • You lose Medi-Cal coverage.
  • You lose your employer-sponsored coverage.
  • Your COBRA coverage is exhausted. Note: Not paying your COBRA premium is not considered loss of coverage.
  • You are no longer eligible for student health coverage.
  • You turn 26 years old and are no longer eligible for a parent’s plan.
  • You turn 19 years old and are no longer eligible for a child-only plan.

Permanently moved to/within California
Examples:

  • You move to California from out of state.
  • You move within California and gain access to at least one new Covered California health insurance plan.

Had a baby or adopted a child
(If you receive a child in foster care, you will also qualify for a special enrollment period but will need to indicate “adopted a child” in the drop-down menu.)
Examples:

  • A child is born, adopted or received into foster care. The entire family can use the special enrollment period to enroll in coverage.
  • If you place your child for adoption or foster care, you can use a special enrollment period to enroll in coverage.

Got married or entered into domestic partnership
Example:

  • One or both members of the new couple can use the special enrollment period to enroll in coverage.

Returned from active duty military service
Example:

  • You have lost coverage after leaving active duty, reserve duty, or the California National Guard.

Released from jail or prison


Gained citizenship/lawful presence
Example:

  • You become a citizen, national, or permanent legal resident.

Federally Recognized American Indian/Alaska Native
Example:

  • If you are a member of a federally recognized American Indian tribe, you can enroll at any time and change plans once per month.

Other qualifying life event
Examples:

  • You are already enrolled in a Covered California plan and become newly eligible or ineligible for tax credits or cost-sharing reductions.
  • You are already enrolled in a Covered California plan and you lose a dependent or lose your status as a dependent due to divorce, legal separation, dissolution of domestic partnership, or death.
  • Misconduct or misinformation occurred during your enrollment, including:
  • An agent, certified enroller, Service Center representative or other authorized representative enrolled you in a plan that you did not want to enroll in, failed to enroll you in any plan or failed to calculate premium assistance for which you were eligible.
  • Misrepresentation or erroneous enrollment, including:
  • Incorrect eligibility determination. This includes if you applied during open enrollment and were initially told you were eligible for Medi-Cal and then later determined not to be eligible for Medi-Cal.
  • The health plan did not receive your information due to technical issues.
  • An error in processing your verification documents resulted in an incorrect eligibility result.
  • Incorrect plan data were displayed when you selected a plan: Data errors on premiums, benefits or copay/deductibles were displayed; incorrect plans were displayed; or a family could not enroll together in a single plan.
  • Your health plan violated its contract.
  • Exceptional circumstances occurred on or around plan selection deadlines, including natural disasters and medical emergencies.
  • You received a certificate of exemption for hardship from Health and Human Services for a month or months during the coverage year but lost eligibility for the hardship exemption outside of an open enrollment period.
  • You and your dependents, if any, are victims of domestic abuse or spousal abandonment (please select “Other qualifying life event” in the drop-down menu and “Single” or “Head of Household” in the “Personal Data-Tax Information” section of the application).
  • You are required by court order to provide health insurance for a child who was been determined ineligible for Medi-Cal and CHIP, even if you are not the party who  expects to claim the child as a tax dependent.
  • You lose “share of cost” Medi-Cal coverage by reaching your share of cost.
  • You are a member of AmeriCorps/VISTA/National Civilian Community Corps:
    • If you entered AmeriCorps or one of the other organizations listed above outside of open enrollment.
    • If you ended your service with one of the organizations listed above.
  • You have a non-calendar year health plan (including “grandfathered” and “non-grandfathered” health insurance plan) outside of Covered California that has expired or will soon expire, and you would like to switch to a Covered California health insurance plan instead of renewing your current plan.
  • Your provider left the health plan network while you were receiving care for one of the following conditions:
    • Pregnancy
    • Terminal illness
    • An acute condition
    • A serious chronic condition
    • The care of a newborn child between birth and age 36 months
    • A surgery or other procedure that will occur within 180 days of the termination or start date.