There are a variety of life events and circumstances that may allow you to enroll in a qualified health plan through Maryland Health Connection or change your current plan. Whether you qualify for a special enrollment period depends on the type of event and how it affects your eligibility for coverage.
Examples of life events that may allow you to enroll in coverage through Maryland Health Connection outside of the annual open enrollment period include:
- Getting married or divorced
- Having a child, adopting a child, or placing a child for adoption or in foster care
- Certain changes in income
- Moving to or from Maryland, and certain moves within the state
- Having a change in disability status
- Gaining or losing a dependent
- Certain losses of other health coverage (such as employer ending coverage, or loss of job or employee leaving a job that provides coverage — but not termination for consumer’s failure to pay plan premium)
- Becoming ineligible for Medicaid or MCHP
- Turning 26 years old if you are enrolled in coverage through your family’s plan
- COBRA coverage period ends
- Other changes that may affect eligibility include: change in tax filing status; change of citizenship or immigration status; incarceration or release from incarceration; change in status as an American Indian/Alaska Native or tribal status
- Certain errors or exceptional circumstances. These are reviewed on a case-by-case basis.
You also should report other changes that may not affect your eligibility for coverage, such as corrections to name, date of birth, or Social Security number.
As part of the eligibility decision process, you may be asked to provide documentation regarding your income, lawful presence, incarceration status and/or American Indian or Alaska Native affiliation.
It is important to note that generally you cannot qualify for a Special Enrollment Period if you lose your health coverage because you stopped paying your premiums. Also, there is no Special Enrollment Period available to people because they become ill, develop a chronic condition or have an accident.
Becoming pregnant is not considered a life event that triggers a special enrollment period to enroll in a qualified health plan through Maryland Health Connection outside of open enrollment or to change your current health plan. However, giving birth will qualify you for a special enrollment period. If you are pregnant, you should report this information to Maryland Health Connection as soon as possible because you may qualify for Medicaid. You can apply for Medicaid at any point during your pregnancy.
As of Jan. 1, 2020, women who become pregnant will be eligible to enroll in health coverage outside of open enrollment or to change their current health plan.