What specific life events qualify me for a Special Enrollment Period to get health insurance outside of open enrollment in California?
In California, you can get health insurance outside of open enrollment if you experience a specific "qualifying life event." These events generally involve a change in your household, loss of other health coverage, or a change in your residence.
Here is how to apply for coverage during a Special Enrollment Period:
Step 1: Identify Your Qualifying Life Event
You must have experienced a qualifying life event. Common examples include:
- Losing health coverage from a job.
- Getting married or entering a domestic partnership.
- Having a baby, adopting a child, or placing a child for adoption.
- Permanently moving to a new area with different health plan options.
- Turning 26 and losing coverage from a parent's plan.
- A change in income that affects your eligibility for financial help.
- Becoming a citizen or having a change in immigration status.
Step 2: Act Within the 60-Day Deadline
You must apply for coverage within 60 days of the date of your qualifying life event. For some events, like an upcoming move or birth of a child, you can apply up to 60 days in advance. If you miss this deadline, you will likely have to wait for the next open enrollment period.
Step 3: Gather Your Proof Documents
You will need to provide documentation proving your life event. Examples include a letter from your former employer stating when your coverage ended, a marriage certificate, a birth certificate, or a new lease agreement or utility bill showing your new address.
Step 4: Apply Through Covered California
The easiest way to apply is through the official state marketplace at www.coveredca.com. You can also apply by phone, with the help of a certified insurance agent, or directly with an insurance company that offers off-exchange plans.
Important considerations:
Voluntarily canceling your previous health plan or being terminated for not paying your premiums does not qualify you for a Special Enrollment Period. The loss of coverage must be involuntary. The effective date of your new plan will depend on when you complete your application.
Note:
Be sure to submit your application and all required documents before the 60-day deadline expires. Covered California is the final authority on whether your event qualifies you for special enrollment.
This is general information and does not constitute legal advice. For complex situations, consult with a qualified California attorney.
Useful Links
Disclaimer:
This information is for general guidance only and should not be considered as legal advice. Please consult with a qualified attorney for specific legal matters.
Views: 37
Updated: August 13, 2025
Health Insurance
Health coverage, medical claims, and insurance rights
View All Questions