Simplifying Benefits
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From the Experts

What is a qualifying Life Event (QLE)?

A change in your situation — like getting married, having a baby, or losing health coverage — that can make you eligible for a Special Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment Period.

There are 4 basic types of qualifying life events. (The following are examples, not a full list.)

  • Loss of health coverage

    • Losing existing health coverage, including job-based, individual, and student plans

    • Losing eligibility for Medicare, Medicaid, or CHIP

    • Turning 26 and losing coverage through a parent’s plan

  • Changes in household

    • Getting married or divorced

    • Having a baby or adopting a child

    • Death in the family

  • Changes in residence

    • Moving to a different ZIP code or county

    • A student moving to or from the place they attend school

    • A seasonal worker moving to or from the place they both live and work

    • Moving to or from a shelter or other transitional housing

  • Other qualifying events

    • Changes in your income that affect the coverage you qualify for

    • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

    • Becoming a U.S. citizen

    • Leaving incarceration (jail or prison)

    • AmeriCorps members starting or ending their service