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Special Circumstances

You may qualify for a special enrollment period (SEP) if your situation fits one or more of these scenarios. 

AmeriCorps Service

You may qualify for a SEP if you are an AmeriCorps member starting or ending your service.

  • 60-day SEP begins: Date of start or end of AmeriCorps service.
  • When you can enroll: Any time during the 60-day window of your SEP.
  • When coverage starts: 
    • If we received your plan selection the 1st-15th of the month, your coverage starts the following month.
    • If we received your plan selection the 16th-end of the month, your coverage starts the 1st of the second following month.
  • Note: Coverage cannot start until your AmeriCorps service begins.

Circumstances Beyond Your Control

You may qualify for a SEP if your failure to enroll during an enrollment period is because of circumstances beyond your control, such as a natural disaster.

  • 60-day SEP begins: Case by case for circumstances out of individual's control.
  • When to enroll: Case by case.
  • When coverage starts: Case by case.

Not Eligible for Medical Assistance after Final Determination

You may qualify for a SEP if you apply for coverage during an annual open enrollment period or for a special enrollment period and you are first determined eligible for Medical Assistance (MA) pending verification, but upon verification after the end of the enrollment period, you are determined ineligible for MA and instead are eligible for a qualified health plan (private plan).

  • 60-day SEP begins: Case by case for circumstances out of individual's control.
  • When to enroll: Case by case.
  • When coverage starts: Case by case.

Victim of Domestic Abuse or Spousal Abandonment

You may qualify for a SEP if you or your dependents are victims of domestic abuse or spousal abandonment.

  • 60-day SEP begins: Upon request for special enrollment period due to domestic abuse or spousal abandonment.
  • When to enroll: Any time during the 60-day window of your SEP.
  • When your coverage starts: 
    • If we received your plan selection the 1st through the 15th of the month, your coverage starts the following month.
    • If we received your plan selection the 16th through the end of the month, your coverage starts the 1st of the second following month.
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