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Are Weddings a Qualifying Event for Health Insurance?

Are Weddings a Qualifying Event for Health Insurance?

Posted Jun 03, 2016 by Jenifer Dorsey

 

Question: I’m getting married this summer. Will I qualify for a special enrollment period, and will my upcoming wedding impact my health insurance coverage in any other ways? 

Under the Affordable Care Act, if you have gotten married in the past 60 days, you have experienced a change in household size, which is considered qualifying life event.[1] Experiencing a qualifying life event could make you eligible for a special enrollment period. A special enrollment allows you to buy an Obamacare plan or switch to a different one outside of the regular open enrollment period.

If you are covered through a health plan at work, or if you expect to be covered under a spouse’s plan at work, you should check with the Human Resources department to understand their policies and procedures.

Special enrollment length after a qualifying event

For a qualifying life event related to a change in household size, Obamacare special enrollment lasts 60 days.[2] Your special enrollment period begins on the date you get married.

Uninsured and not ready to commit to a new Obamacare plan?

Consider a short term health insurance plan in the meantime.

What is the process for a special enrollment period?

Special enrollment periods apply to health insurance plans sold in the private market as well as those sold on state-based and federally facilitated Obamacare exchanges.

1a. To help determine whether or not you might be eligible for special enrollment, you can fill out a prescreening questionnaire at HealthCare.gov or work with a health insurance producer. However, a prescreening questionnaire is not necessary.

1b. Filling out an application for health insurance will ultimately help you determine whether or not you qualify for special enrollment. You can apply through a state-based or federally facilitated exchange, directly through a health insurance company, with the help of an agent and online using websites such as healthedeals.com.

 

 

2. You may need to provide documentation of your qualifying life event (e.g., a marriage certificate) to prove your eligibility.

3. Once you shop and apply for a plan and pay your first month’s premium, you must wait for your new coverage to take effect. When you experience a special enrollment period due to marriage, you may select and enroll in an Obamacare plan at any point throughout the month and it will begin the first of the following month.

For example, if you buy your new Obamacare plan on June 17, it will begin July 1. 

Work with a health insurance producer to navigate the special enrollment process and determine your coverage options. Call the number at the top of your screen to speak with a certified advisor who can assist you in finding health insurance on and away from the Obamacare exchanges.

Will I still qualify for a tax credit?

Whether or not you change health insurance plans after a qualifying life event—you don’t have to—you should remember to update your financial and household information if you receive an Obamacare subsidy (i.e., premium tax credit and/or cost-sharing subsidy).

 

 

A change in household size due to circumstances such as marriage, births and adoptions, or dependents turning 26, can impact your subsidy eligibility.[3] If you fail to report such changes as they happen, you can be penalized at tax time or miss out on additional subsidy funds for which you become eligible.[4]

 

Mind the gap

As explained above, your new health insurance plan won’t begin immediately. Or, amid the busyness of planning and hosting a wedding, you may need a little time after your special enrollment period begins to shop around and select coverage. As such, you may experience a brief lapse in coverage between when your old plan ends and your new plan begins—if you are currently uninsured, of course, this also applies.

Consider a short term health insurance plan while you wait for your new coverage to begin. Short term plans provide temporary benefits while you are in between Obamacare plans and last as few as 30 days, just long enough to offer some added financial protection during a coverage gap.

Ready to learn more on your own?

Get a short term quote in seconds!*

* No contact information required unless you apply.

Keep in mind that due to their temporary nature, short term health plans are not ACA-compliant. This means they do not fulfill the individual shared responsibility provision (i.e., if you are not exempt and go without minimum essential coverage for three or more months, you could owe a tax penalty) and you can be denied coverage based on your health history.

However, short term plans do provide many benefits to help you pay for unexpected healthcare expenses while you are uninsured. Some plans may even include some basic preventive care benefits. Short term coverage can be obtained within a few minutes and begin as soon as the day after you apply.

Call the number at the top of your screen to speak with a certified advisor who can help determine which short term plan is right for you.

 


 

[1] HealthCare.gov. “Glossary: Special Enrollment Periods.” Accessed May 31, 2016. https://www.healthcare.gov/glossary/special-enrollment-period/

[2] Ibid.

[3] HealthCare.gov. “Reporting Income and Household Changes.” Accessed May 31, 2016. https://www.healthcare.gov/reporting-changes/why-report-changes/

[4] Ibid.

This document is for general informational purposes only. While we have attempted to provide current and accurate information, this information is provided "as is" and we makes no representations or warranties regarding its accuracy or completeness. The information provided should not be construed as legal or tax advice or as a recommendation of any kind. External users should seek professional advice from their own attorneys and tax and benefit plan advisers with respect to their individual circumstances and needs.

SHORT-TERM MEDICAL EXPENSE (STM)
THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.

About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual disability, specialty and supplemental health, pet, and life insurance through its subsidiaries since 1980. The IHC Group (including through its 92% ownership of American Independence Corp. (NASDAQ: AMIC)) owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), a majority of Ebix Health Administration Exchange, Inc., a fully insured third party administrator, and IHC Specialty Benefits, Inc., which is a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.

About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc., doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products via general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit http://www.HealtheDeals.com.