QUESTION

My income has gone down and I think I may now qualify for premium tax credits in the health insurance marketplace. Do I have to wait for an open enrollment period before I can enroll?

Individuals with no coverage | Open and Special Enrollment Periods
ANSWER

It depends. If you are currently enrolled in a marketplace health plan and are newly eligible for a premium tax credit or if you’ve had a change in eligibility for premium tax credits, you qualify for a special enrollment so long as you apply within 60 days of your change in status. You can change plans with this SEP but only within the same metal level as your current plan. If you are not currently in a marketplace plan, you do not qualify for a special enrollment period. (45 C.F.R. § 155.420; 82 Fed. Reg. 18346, April 18, 2017; Special Enrollment Period (SEP) Overview for the Federally-facilitated (sic) Marketplace, July 2018).

Individuals with no coverage
Individuals with coverage
Coverage for small employers
Post enrollment issues