Insurance Benefits Eligibility: Life Events and the Records Behind Them
Insurance benefits eligibility is whether you can enroll in, or change, a health plan, and for whom. Outside the yearly Open Enrollment period, HealthCare.gov says you can generally enroll only if you qualify for a Special Enrollment Period because of a qualifying life event.
What vital record do you need?
Choose your certificate to start your order.
Life events that can qualify
HealthCare.gov defines a qualifying life event as a change in circumstances, such as a change in household or coverage. Its household examples include:
- Marriage
- Having a baby
- Adopting a child or placing a child in foster care
- Divorce or legal separation that causes loss of insurance
- A death in your household that causes loss of your plan
Other qualifying events include losing coverage, moving to a new ZIP code or county, and becoming a U.S. citizen.
Timing
For most events, the change must have happened in the past 60 days. For a new baby, adoption or foster placement, coverage can start on the event date even if you enroll up to 60 days later. For marriage, you pick a plan by the last day of the month for coverage to start the first of the next month.
Records
You attest on the application that the information is true. HealthCare.gov also says you may have to submit documents that confirm your loss of coverage. A birth, marriage, divorce or death certificate is the type of record that documents a household event, though what the Marketplace asks for can vary. Employer plans have their own enrollment rules, so check with the plan.
Frequently asked questions
How long do I have to enroll after a birth or marriage?
HealthCare.gov says the change generally must have happened in the past 60 days.
Does a death in the family qualify?
HealthCare.gov lists a death in your household that causes loss of your plan as a qualifying event.
What documents will the Marketplace ask for?
It depends on the event. The Marketplace will tell you what to submit, so follow its instructions for your case.
Sources
US Records is a private company and is not a government agency. Government agencies issue certified records; we help you order them.
Written By
US Records TeamThe US Records Team writes and reviews guides on birth, death, marriage and divorce certificates, using state statutes, agency instructions and court records as sources.
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