Getting health coverage outside Open Enrollment

When the Marketplace needs documents to confirm a Special Enrollment Period

When you apply for Marketplace coverage and qualify for a Special Enrollment Period, you may be asked to provide documents to confirm the events that make you eligible. You must send the documents before you can start using your coverage.

  • You’ll learn if you have to provide documents after you submit your application. Details and instructions appear on your eligibility results screen and in a notice you can download or receive in the mail.
  • It’s best to pick a plan first and submit your documents afterwards. After you pick a plan, you have 30 days to send the documents.
  • Your coverage start date is based on when you pick a plan. But you can’t use your coverage until your eligibility is confirmed and you make your first premium payment.
  • If your eligibility results don’t say you need to provide documents, you don’t have to. Simply pick a plan and enroll.
  • Ready to upload now? Follow these steps.

Documents & deadlines for your life event

Select your life event for the documents you can submit and key dates:

If you’re losing health coverage

You must send documents showing the lost coverage and the date it ends.

Key dates: Special Enrollment Periods due to a coverage loss
Status of coverage loss Pick a plan within… Documents must be submitted within… Coverage starts, if premium paid

Already lost coverage

60 days after date coverage ended

30 days of picking a plan

First day of month after you pick a plan

Will lose coverage in the future

60 days before date coverage will end

30 days of picking a plan

First day of month after your coverage ends and you pick a plan

If you moved to a new address and had prior coverage

You must provide documents that confirm both of these:

  • You moved in the last 60 days
  • You had health coverage at least one day during the 60 days before your move
    • Acceptable documents include correspondence from your insurance company, employer, or health coverage provider, like a government agency.
    • See a full list of acceptable documents to confirm you had health coverage.
    • Note: If you’re moving from a foreign country or U.S. territory, you don’t have to prove you had health coverage. But the documents you submit must show a move from a foreign country or U.S. territory.
Key dates: Special Enrollment Periods due to a move
Pick a plan within… Documents must be submitted within… Coverage starts, if premium paid

60 days after the date you moved

30 days of picking a plan

Plan picked between 1st and 15th of month: First day of next month.

Plan picked between 16th and last day of month: First day of second month following plan selection.

If you gained or became a dependent due to an adoption, foster care placement, or court order

You must send documents showing the name of the person(s) who became a dependent and the date they became one.

Key dates: Special Enrollment Periods due to gaining a dependent
Pick a plan within… Documents must be submitted within… Coverage starts, if premium paid

60 days after the event

30 days of picking a plan

Coverage will go back to the date of adoption, foster care placement, or date that the court order took effect.

Need a different start date? Contact the Marketplace Call Center.

If you got married

You must send documents showing the names of the people who got married and the date of the marriage.

Key dates: Special Enrollment Periods due to marriage
Pick a plan within… Documents must be submitted within… Coverage starts, if premium paid

60 days after marriage

30 days of picking a plan

First day of month after you pick a plan

If you were denied Medicaid or Children’s Health Insurance Plan (CHIP) coverage outside Open Enrollment after you applied during it

You must send documents showing the name of the person who was denied Medicaid or CHIP coverage and the date they were denied.

Special Enrollment Periods due to Medicaid/CHIP denial outside of Open Enrollment after you applied during it
Pick a plan within… Documents must be submitted within… Coverage starts, if premium paid

60 days after denial

30 days of picking a plan

First day of month after you pick a plan

Need a different start date? If you originally applied through the Marketplace, contact the Marketplace Call Center to request that your coverage start back to the date it would have started if the Marketplace had originally determined you eligible for a Marketplace plan.

How to submit documents

You should provide the required documents as soon as possible after you pick a plan. This will prevent a delay in your coverage starting. You can submit documents two ways:

Upload

  • This is the fastest and most efficient way to get us the documents.
  • You’ll need to have scanned images of your documents on your computer. Clear photos of the documents are acceptable.
  • Document format requirements:
    • Accepted formats: .pdf, .jpeg, .jpg, .gif, .xml, .png, .tiff, .bmp
    • Maximum file size: 10MB
    • File names can’t include special characters like / \ : * ? “ < > |
  • Once you have the documents on your computer, log in to HealthCare.gov to upload them. Follow these step-by-step instructions or log in now.

Mail

  • Do not send original documents: send photocopies only.
  • Mail documents to this address:

    Health Insurance Marketplace
    Attn: Supporting Documentation
    465 Industrial Blvd.
    London, KY 40750-0001

After you submit your documents

You should get a letter or notice in your HealthCare.gov account within a couple of weeks. It’ll say if your Special Enrollment Period has been confirmed.

  • If your Special Enrollment Period is confirmed:

    • We’ll send the confirmation to the insurance plan you picked.
    • You’ll need to pay your first premium directly to the insurance company — not to the Health Insurance Marketplace. Your coverage won’t start until you pay your first premium.
    • If confirmation delays kept you from using your plan after the coverage start date, you may have to pay premiums for one or more previous months. When you do, medical expenses you had after the start date may be covered. This is called “retroactive” coverage.
  • If your Special Enrollment Period can’t be confirmed using the submitted documents:

    • You’ll get a letter or notice in your Marketplace account explaining why.
    • You can upload one or more different documents to confirm.
    • If you don’t have any of the acceptable documents, you can send a written statement explaining why. Learn more about what to include in the statement.

More answers: Confirming a Special Enrollment Period

What if I don’t pick a plan within 60 days of moving or losing coverage?

Your Special Enrollment Period eligibility has passed. You can’t enroll in a health insurance plan until the next Open Enrollment, unless you qualify for another Special Enrollment Period.

How do I confirm a move if I'm homeless or in transitional housing?

You can submit a letter from a person in your state who can confirm you live in the area. It could be a friend, family member, or caseworker.

This person must confirm their residency by including one of the documents listed here.

What if I don’t have any of the acceptable documents?

First, do whatever you can to get them. Sending the right documents is the best way start using your coverage as soon as possible.

If you’ve tried everything and still can’t get the documents, you can provide a written statement instead.

  • If you qualify for a Special Enrollment Period because you moved: Submit a written statement that includes the date you moved, your old and new addresses, and the reason you can’t submit documents to confirm.
  • If you qualify for a Special Enrollment Period due to losing coverage: Submit a written statement that includes the name of the plan you had, the date of the coverage loss, and the reason you can’t submit documents to confirm.

If you’ve tried everything and still can’t get the documents, you can provide a written statement instead.

  • If you qualify for a Special Enrollment Period because you moved: Submit a written statement that includes the date you moved, your old and new addresses, and the reason you can’t submit documents to confirm.
  • If you qualify for a Special Enrollment Period due to losing coverage: Submit a written statement that includes the name of the plan you had, the date of the coverage loss, and the reason you can’t submit documents to confirm.
  • If you qualify for a Special Enrollment Period because you gained or became a dependent: Submit a written statement that includes the name of the person who was adopted, placed in foster care, or became a dependent through a court order, the date of the adoption, foster care placement, or effective date of the court order; and the reason you can’t submit documents to confirm.
  • If you qualify for a Special Enrollment Period because you got married: Submit a written statement that includes the names of the people who got married, the date of the marriage, and the reason you can’t submit documents to confirm.
  • If you qualify for a Special Enrollment Period because you were denied Medicaid or CHIP outside of Open Enrollment after applying during Open Enrollment: Submit a written statement that includes the names of the people denied coverage, the date they were denied, and the reason you can’t submit documents to confirm.

The Marketplace will take your statement into consideration and let you know if it’s acceptable confirmation.

Can I submit my documents before I pick a plan?

Yes, but you must pick a plan within 60 days of the event that qualifies you for the Special Enrollment Period.

If you don’t, you won’t be able to enroll until 2018 Open Enrollment from November 1 - December 15, 2017 (unless you qualify for another Special Enrollment Period).