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I’m enrolled in student health coverage now, but now I think I can get a better deal in the Marketplace. Can I drop student health plan coverage and go to the Marketplace instead?

If you are currently enrolled in a student health plan, you can still qualify for Marketplace policies and subsidies if you apply during Open Enrollment. During Open Enrollment, you can sign up for a Marketplace plan and, if your income is between 100% and 400% of the poverty level you can also apply for premium tax credits. You will have to drop your student health coverage by December 31 in order to remain eligible for premium tax credits for the following year.

Outside of Open Enrollment, you cannot voluntarily drop your student health plan coverage in order to qualify for Marketplace coverage and premium tax credits. However, if you involuntarily lose eligibility for student health plan coverage mid-year – for example, if you drop out of school and so lose eligibility for the student health plan – you will qualify for a “coverage loss” special enrollment opportunity and be able to apply for Marketplace coverage and premium tax credits. The “coverage loss” special enrollment period (SEP) will last 60 days from the date your student health coverage ends.  If you know in advance when coverage will end, you can also apply for the SEP up to 60 days in advance.  If you apply in advance, you can elect to have new coverage begin the following day and avoid a gap in coverage.

If you live in a healthcare.gov state, you will need to provide proof of coverage loss to qualify for this SEP — for example, a letter or notice from the school stating when coverage will end.

Log into your healthcare.gov account to apply for the SEP and select a new health plan.  You will then have 30 days to provide documentation to the Marketplace  Once the Marketplace verifies your eligibility, you will be able to complete enrollment in the plan you selected.

It is very important to act quickly to complete this verification process.  If you do not submit the required documentation within 30 days, your plan selection will be cancelled and you will no longer be eligible for the SEP.  If you submit documentation on time but the Marketplace determines it to be insufficient, you can apply for an extension of the 30-day review period to submit additional documentation.  However, you cannot apply for an extension of your SEP.  If your eligibility is not verified by the end of your 60-day SEP, your plan selection will be cancelled and you will not be able to enroll until the next Open Enrollment Period.

If you have questions contact a Navigator or other Marketplace assister program for help.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
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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.