Special Enrollment

Outside of Open Enrollment, coverage might still be available to you at Your Health Idaho. Certain life changing events can qualify you for a Special Enrollment Period, which allows individuals and families to enroll in a new insurance plan. If you are enrolled already, a Special Enrollment Period allows you to change plans.

If you believe you have a life changing event that qualifies for a Special Enrollment Period, you will have 60 days from the date of your event to complete the following:

  1. Report your life changing event or change.
  2. Provide documentation to prove the event and eligibility.
  3. Select and enroll in a plan.

The life changing events listed below might qualify you for a Special Enrollment Period. Select the life changing event that best represents your change to see a brief description and required documentation.

Loss of Health Insurance

Losing health insurance means that you stopped receiving insurance coverage that provided minimum essential benefits.

  • Employers’ insurance
  • COBRA
  • Marketplace coverage
  • Private insurance
  • Medicare, Medicaid, CHIP
  • Tricare
  • PeaceCorps, AmeriCorps

These documents prove eligibility:

  • Dated termination letter from your employer (letter must clearly state that termination resulted in a loss of coverage and include the coverage end date)
  • Dated letter of fund exhaustion from PERSI (sent three months prior to exhaustion of funds)
  • COBRA notice of termination of employer contribution to enrollment
  • Employer letter of exhaustion of contribution to COBRA enrollment
  • COBRA cancellation letter
  • Termination letter from your health insurance company
  • Termination letter from a government provider (e.g., Medicaid)

Provide documentation of previous coverage and of age.

Provide documentation of previous coverage and one of these documents to prove eligibility:

  • Copy of death certificate
  • Signed affidavit
  • Newspaper obituary
  • Mortuary notice

Provide a copy of the Health and Human Services exemption certification.

Change in Household Size

Your family size and demographics can affect your eligibility for marketplace insurance.

  • Birth of baby
  • Adoption
  • Court-appointed ward

These documents prove eligibility:

  • Birth certificate
  • Court order for guardianship, adoption, or foster care
  • Evidence of right to control health care of dependent

Provide documentation of previous coverage for at least one partner and one of these documents to prove eligibility:

  • Marriage certificate
  • Copy of court order, decree, or petition for name change for marriage
  • Domestic legal document

Provide documentation of previous coverage and one of these documents to prove eligibility:

  • Copy of divorce papers
  • Papers of legal separation
  • Court order papers for dissolution of partnership
  • Validation on the Idaho repository

Change of Address

Moving in state, or your primary tax filer moving out of state, can affect you or your household’s ability or eligibility to get coverage through the marketplace. Not all moves will result in a Special Enrollment Period.

  • Moved in state
  • Moved to a new county or zip code
  • Primary tax filer moved out of state

Provide a combination of documents to prove eligibility:

  • Proof of health insurance coverage within 60 days prior to the move.

AND

Either:

  • Driver’s license
  • Voter registration card

Or, two of the following:

  • Student college enrollment letter
  • Automobile registration
  • Rental agreement
  • Home purchase agreement
  • Utility bills with previous and new addresses
  • Property tax notice with homeowner’s exemption
  • Home payment notice
  • Offer of employment
  • U.S. Postal Service change of address
  • DMV change of address certificate card

Change in Financial Status

Your income change, and certain household financial changes, might allow you to change plans or apply newly received tax credits.

  • Cost sharing reduction amount changed
  • Newly eligible or ineligible for advanced payments of premium tax credits

Fill out the Special Enrollment Period—Justification and Verification Form.

Contact Your Health Idaho at 1-855-YH-IDAHO or email Support for help.

Special Circumstances

Exceptional circumstances can impact your insurance coverage or your access to enrollment resources. For help understanding if you qualify for a Special Enrollment Period because of a life changing event or other complex cases, contact Your Health Idaho at 1-855-YH-IDAHO or find an agent to assist you.

These documents prove eligibility:

  • Copy of immigration papers
  • Copy of certificate of naturalization
  • Certificate of U.S. citizenship
  • U.S. birth certificate
  • Resident alien card
  • Other official documentation that shows legal status
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