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How does the “permanent move” special enrollment work?

If you move to or within a healthcare.gov state, you will be eligible for a special enrollment period only if you had previously been enrolled in other coverage.  You must have been enrolled in minimum essential coverage (such as a job-based plan, Marketplace plan, or Medicaid) for at least 1 day in the 60 days preceding the date of the permanent move in order to qualify for the permanent move special enrollment period.

There are exceptions to this rule:

  • If you previously lived in a state that did not expand Medicaid eligibility and were ineligible for Marketplace coverage in that state because your income was below the poverty level, and if you move to another state where you become newly eligible for premium tax credits, you will be eligible for the permanent move special enrollment period when you move to the new state
  • If you moved from outside of the United States or a U.S. territory, you are eligible regardless of prior coverage
  • If you are newly released from incarceration, you are eligible regardless of prior coverage

The permanent move SEP lasts 60 days from the date of your move.  Coverage will start on the first day of the following month; or, if you select your new plan after the 15th of the month, new coverage will start on the first day of the second following month.  In healthcare.gov states, you will not be able to apply for the permanent move SEP in advance of your move date.    As a result, people who move to or within healthcare.gov states may experience a break in coverage while they wait for their new plan to take effect.

When you apply for the permanent move SEP in a healthcare.gov state, you will be required to provide documentation of your prior address, your new address, and evidence of loss of prior coverage.

State-run Marketplaces have flexibility to expand special enrollment opportunities for consumers. Check with your State Marketplace for more information.

 

 

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.