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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics

Featured

Featured
6 lessons Mary Lou Retton’s health scare can teach us about coverage
Mary Lou Retton’s health scare story included some important lessons for consumers, many of whom may assume that the celebrity’s health scare is a sign of barriers to affordable health coverage.
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Frequently-asked questions by tag

What happens if I don’t make my premium payment by the end of the grace period? photo

What happens if I don’t make my premium payment by the end of the grace period?

February 20, 2024 – If you fail to pay your premiums and exhaust the grace period for plans offered in a health insurance marketplace, you will lose your…

If I have insurance through my employer, can my spouse get coverage through the exchange? photo

If I have insurance through my employer, can my spouse get coverage through the exchange?

February 14, 2024 – If you have insurance through your employer, and your spouse is unemployed, they can get insurance through the Marketplace but cannot get a…

I am on Medicare and Social Security. My wife is self employed and needs insurance from the state exchange. How do we figure our household income? photo

I am on Medicare and Social Security. My wife is self employed and needs insurance from the state exchange. How do we figure our household income?

February 5, 2024 – For the purpose of determining subsidy eligibility, the IRS and the health insurance exchanges use an ACA-specific version of modified…

I’m 60 and retired. I can get insurance from my former employer but it’s very expensive. Do I qualify for insurance in the Marketplace? photo

I’m 60 and retired. I can get insurance from my former employer but it’s very expensive. Do I qualify for insurance in the Marketplace?

February 5, 2024 – But for retirees, the guidelines are more relaxed. Retirees who have access to a plan that provides minimum essential coverage can still…

Can health insurance policies still have lifetime or annual benefit maximums? photo

Can health insurance policies still have lifetime or annual benefit maximums?

January 19, 2024 – All new individual and small-group plans have covered essential health benefits (EHBs) since 2014, and there cannot be dollar limits on…

How does my access to employer-sponsored coverage impact my eligibility for subsidized coverage through the exchanges? photo

How does my access to employer-sponsored coverage impact my eligibility for subsidized coverage through the exchanges?

January 18, 2024 – Fortunately, the IRS issued new rules, effective in 2023, to allow some families to take advantage of premium subsidies in the exchange if…

If I enroll in the exchange, will that coverage take effect immediately? photo

If I enroll in the exchange, will that coverage take effect immediately?

January 11, 2024 – If you enroll through your marketplace your coverage effective date mostly depends on whether you're enrolling during open enrollment or a…

Who can help if I have a problem with my ACA-compliant coverage or exchange enrollment? photo

Who can help if I have a problem with my ACA-compliant coverage or exchange enrollment?

January 8, 2024 – Here's where you should look for help if have trouble enrolling through a health insurance marketplace – or if you have issues with your…

What type of health insurance exchange does my state have? photo

What type of health insurance exchange does my state have?

December 4, 2023 – As of the 2024 plan year, there will be 19 fully state-run health insurance marketplaces (SBMs), three state-based marketplaces that use…

If my income is less than expected this year, I might be eligible for Medicaid. What can I do to cover my bases? photo

If my income is less than expected this year, I might be eligible for Medicaid. What can I do to cover my bases?

November 13, 2023 – Income volatility and its impact on subsidy eligibility have been addressed by various provisions of the ACA and IRS regulations. But since…

Is pediatric dental coverage included in exchange plans? photo

Is pediatric dental coverage included in exchange plans?

November 1, 2023 – There is no penalty for not having pediatric dental on your policy – and in most exchanges, you can purchase a plan without pediatric…

If I don’t enroll in a plan by the open enrollment deadline, what are my options? photo

If I don’t enroll in a plan by the open enrollment deadline, what are my options?

September 18, 2023 – Your options for coverage are very limited if you don't enroll in a plan by the end of open enrollment in your state. The open enrollment…

I earn too much to qualify for a subsidy. Why should I buy through the exchange? photo

I earn too much to qualify for a subsidy. Why should I buy through the exchange?

September 8, 2023 – The American Rescue Plan (ARP), enacted in March 2021, makes health insurance coverage more affordable for millions of people who buy their…

My parents are 68, but recently moved to the U.S., so they don’t qualify for Medicare. Can they buy insurance in the exchange? photo

My parents are 68, but recently moved to the U.S., so they don’t qualify for Medicare. Can they buy insurance in the exchange?

September 8, 2023 – If your parents are 65 or older but don't qualify for premium-free Medicare Part A, they can purchase a private plan in the Marketplace and…

Are visits to the chiropractor or physical therapist covered under the Affordable Care Act? photo

Are visits to the chiropractor or physical therapist covered under the Affordable Care Act?

September 5, 2023 – All ACA-compliant individual and small group plans include coverage for physical therapy. Some individual market plans, sold via the health…

I’m 21, single with no kids, living with my parents and going to school full time. Do I apply for health insurance as a household of one and list only my income? photo

I’m 21, single with no kids, living with my parents and going to school full time. Do I apply for health insurance as a household of one and list only my income?

July 31, 2023 – You can get your own health insurance policy, but since you're counted as a dependent on your parents' tax return, your household income…

Should I buy the health plan my college offers? or buy through an ACA exchange? photo

Should I buy the health plan my college offers? or buy through an ACA exchange?

July 31, 2023 – Most student health plans offered by colleges and universities are fully compliant with the ACA, with just a few exceptions that don't…

How is vision care covered under the Affordable Care Act? photo

How is vision care covered under the Affordable Care Act?

June 29, 2023 – The Affordable Care Act requires coverage for pediatric vision care as one of the essential health benefits. But there is no requirement…

Can small businesses use the ACA’s health insurance marketplaces (exchanges)? photo

Can small businesses use the ACA’s health insurance marketplaces (exchanges)?

June 29, 2023 – The Affordable Care Act included an enrollment platform called SHOP (Small Business Health Options Program), an exchange where businesses…

Do Gold exchange plans offer more generous coverage than Bronze or Silver plans? photo

Do Gold exchange plans offer more generous coverage than Bronze or Silver plans?

June 23, 2023 – All plans (whether Bronze, Silver, Gold or Platinum) must cover the same essential benefits, including free preventive care; they all…

Are dental benefits included in ACA’s marketplace health plans? photo

Are dental benefits included in ACA’s marketplace health plans?

April 7, 2023 – Pediatric dental is one of the ACA's essential health benefits. But there's no requirement that dental care for adults be…

If all Silver plans cover the same benefits and percentage of costs, why do premiums vary by carrier? photo

If all Silver plans cover the same benefits and percentage of costs, why do premiums vary by carrier?

July 5, 2022 – It's important to understand that the benefits offered by plans at the same metal level can vary significantly from one plan to another.…

Would my 21-year-old’s subsidy be based on his income – or mine? photo

Would my 21-year-old’s subsidy be based on his income – or mine?

April 26, 2022 – If you declare him as a dependent on your income tax, then your income would be included in determining whether he gets a…

Did health insurance premiums go up or down for 2021? photo

Did health insurance premiums go up or down for 2021?

August 18, 2021 – The vast majority of Americans get their health insurance either from an employer or from the government (Medicare, Medicaid, CHIP,…

My doctor posted a sign saying she ‘doesn’t take Obamacare.’ What should I do? photo

My doctor posted a sign saying she ‘doesn’t take Obamacare.’ What should I do?

August 3, 2021 – It depends on your relationship with your doctor. If you're not particularly attached to her, it might be easier to just find someone new.…