Certain life changes and special circumstances may allow you to sign up beyond the open enrollment period (November 15, 2014-February 15, 2015).
Medicaid enrollment is available year-round. Applications for Medicaid enrollment will continue throughout the year; you do not need to qualify for a special enrollment period in order to apply for Medicaid benefits. If anyone in your family is eligible for Medicaid, coverage will be effective back to the first day of the month in which you applied. Go to www.marylandhealthconnection.gov to see if you may be eligible for Medicaid coverage.
In addition, there are other circumstances that may allow you to enroll in coverage or change plans outside of the annual open enrollment period.
- 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
- Becoming pregnant
- 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 (Maryland Children’s Health Program)
- 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
The life changes listed may adjust the coverage and/or savings you may be eligible to receive. You should also report other changes that may not affect your eligibility for coverage, such as address changes, corrections to name, date or 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, become pregnant or have an accident.
Whether you qualify for a special enrollment period depends on the type of event and how it affects your eligibility for coverage.
Real-Life Stories (from Maryland Health Connection website)
Maryland residents tell about their experiences with illness, injuries and insurance costs. We showed them the difference health coverage could make. Here’s one example of what they had to say:
Visit the Maryland Health Connection website for additional real-life stories and how they discovered the difference health coverage could make.
Why is Health Insurance Important?
Health insurance protects you and your family from large debts due to unexpected medical costs such as medical emergencies, surgery or a serious illness. An unexpected illness or injury can happen to anyone, even to someone who is young and healthy. Without health coverage, or without enough coverage, an illness or injury can drain savings. High medical bills are a leading cause of personal bankruptcy in the United States.
What is the Affordable Care Act (ACA)?
The Patient Protection and Affordable Care Act was signed into law in March 2010 and the law is intended to:
- Provide universal access to health care coverage for Americans.
- Control the rising cost of health care services.
- Regulate private insurance through things like state-based private exchanges—an online marketplace where consumers can shop for state-approved insurance plans
- Improve the quality of health care
The individual mandate is the core of the Affordable Care act and it requires everyone to have health insurance coverage either through their work place, from a government program like Medicaid or Medicare, or buy health insurance on their own. Anyone without coverage will have to pay a penalty (fee).