eHealth Explains How to Get Health Insurance Beyond Open Enrollment After Federal Government Tightens Obamacare Requirements

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MOUNTAIN VIEW, CA --(Marketwired - January 28, 2016) - Today eHealth, Inc. EHTH (eHealth.com), the nation's first and largest private online health insurance exchange, described the paperwork people may need in order to prove they have had a qualifying life event that allows them to get health insurance after Obamacare's nationwide open enrollment period ends on January 31, 2016.

The Centers for Medicare and Medicaid Services (CMS) recently announced that they have retired certain qualifying life events for consumers searching for coverage outside of the Affordable Care Act's nationwide open enrollment period. CMS has also made it more difficult to qualify for some of the special enrollment opportunities that are still available1.

Qualifying Life Events - And How to Prove You Are Eligible

The following describes common qualifying life events that may allow you to enroll in a major medical health insurance plan after open enrollment ends, as well as the paperwork you may need to provide in order to show that you're eligible.



-- Loss of qualifying employer coverage: Some insurers require a letter
from your former employer that confirms your loss of coverage as well as
the date and the reason it occurred. The letter should include the names
of the employee and dependents affected. Some insurers will accept a
letter showing eligibility for COBRA if it provides the same details
listed above.
-- Loss of COBRA coverage: If you were previously insured through COBRA,
some insurers require you to provide a copy of the letter you should
have received stating that your COBRA coverage has now been exhausted.
-- Birth or adoption of a child: Some insurers require a copy of the
child's birth certificate and/or placement or adoption papers, with a
court seal.
-- Adding a new dependent: When a child moves in with you for reasons other
than birth or adoption, you may need to provide a copy of a court order
(in case of a divorce or custody settlement) or school admissions
documentation or transcripts.
-- A permanent move to a new coverage area: You may be required to show
copies of utility bills from both your former and the new residence,
dated within sixty days of the date of your move. Mobile phone bills and
bank statements are typically insufficient.
-- Marriage or divorce: A copy of the marriage license (translated into
English, if necessary) or a court-stamped copy of the divorce decree may
be required.
-- Change of income that alters your eligibility for assistance: You may be
required to provide documentation of your eligibility for subsidies.
This is generally obtained through the government health insurance
exchange serving your state.



What to Expect When Enrolling in Coverage with a Qualifying Life Event

You may have questions about what to expect when enrolling in coverage outside of the nationwide open enrollment period. Here are a few things you should know:



-- You have sixty days to enroll. If you experience one of the qualifying
life events described above, you will typically have a sixty-day window
to enroll in a new health insurance plan.
-- Loss of prior coverage due to lack of payment is not a qualifying life
event. If your old plan was cancelled because you failed to pay your
monthly premiums, this is not considered a qualifying life event and
will not allow you to enroll in a new plan outside of the nationwide
open enrollment period.
-- Not all major life events are considered "qualifying" life events. For
example, pregnancy is not considered a qualifying life event, though the
birth of a child is. If you were previously uninsured at your old
address, moving to a new coverage area is not considered a qualifying
life event. Cancelling coverage under your old plan because it is too
costly or cancelling your COBRA coverage because it is too costly are
not qualifying life events. Loss of coverage under a short-term health
insurance plan is not a qualifying life event.
-- Having your paperwork handy can speed things up. It can be difficult to
obtain the paperwork you may need from former employers or utility
companies proving that you have experienced a qualifying life event.
Work to obtain these things as quickly as possible after your qualifying
life event so that your sixty-day special enrollment window doesn't
close before you can sign up for a new plan.
-- It can take a few weeks to confirm your eligibility: The time required
for an insurance company to confirm your eligibility to enroll may vary
from insurer to insurer. It may take 2-3 weeks in some cases, or even
longer at busy times of year. Note that your coverage will generally not
take effect immediately after approval, but may require 2-6 weeks from
the date your application is approved.



Notes:

1 Refer to the January 19, 2016 CMS announcement on retired special enrollment periods and to the January 19, 2016 CMS clarification on residency requirements for special enrollment periods.

eHealth
eHealth, Inc. EHTH owns eHealth.com, the nation's first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealth offers thousands of individual, family and small business health plans underwritten by many of the nation's leading health insurance companies. eHealth (through its subsidiaries) is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth also offers educational resources and powerful online and pharmacy-based tools to help Medicare beneficiaries navigate Medicare health insurance options, choose the right plan and enroll in select plans online through PlanPrescriber.com (www.PlanPrescriber.com), eHealthMedicare.com (www.eHealthMedicare.com) and Medicare.com (www.Medicare.com).

For more health insurance news and information, visit the eHealth consumer blog: Get Smart - Get Covered or visit eHealth's Consumer Resource Center.


FOR FURTHER INFORMATION PLEASE CONTACT:

For media inquiries, please contact:

Sande Drew
DMA Communications for eHealth, Inc.
(916) 207-7674
sande.drew@ehealth.com

Nate Purpura
eHealth, Inc.
(650) 210-3115
nate.purpura@ehealth.com

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Posted In: Press Releases
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