How to Switch to Marketplace Coverage After Employer Coverage?
Hello, my wife is about to have our second child. we currently have health coverage through my employer, and will through the birth of the baby. we will be moving to Maine (04097), from Colorado (81615), in mid June and our coverage will no longer be available since we will be both be leaving our current employers. Assuming that we do not have work lined up (and health benefits through our employment), we are interested in the obamacare program since the gold level is approximately 50% of the cost of going to a COBRA program from my employer. We have a 3 year old who will be 4 in august. I am 38, and my wife is 32. I went through the initial screening to see if we may qualify for a marketplace application even though the window has passed for 2014, and it did say that we would most likely qualify. What would our next steps be (knowing when our employment will end), and how long will it take to get our coverage to kick in?
Answer
If you are losing employer coverage you can switch to Marketplace coverage by enrolling in the Marketplace no less than 15 days before employer coverage ends. When employer coverage ends you get a 60 day special enrollment window to enroll in a Marketplace plan outside of open enrollment. To avoid a gap in coverage you'll want to make sure you are enrolled in a new plan no less than 15 days before you lose coverage. This is because, typically, coverage purchased before the 15th of the month starts on the 1st of the next month.
Please note CORRECTION: Special enrollment should negate the need to enroll by the "15th" of a month and coverage should simply begin at the start of the next month. Only coverage obtained during open enrollment follows the 15 day rule. The above text will remain to help people understand how the two enrollment types differ.
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This is not correct. If you are getting into the Marketplace due to loss of coverage, Marketplace coverage will begin on the first day of the following month.
If you trigger the “Loss of minimum essential coverage” Special Enrollment Period (SEP), Marketplace coverage simply begins at the start of next month.
Really great catch, thank you for clarifying that. You are correct.