Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

These rules went into effect for plan years beginning on or after January 1, 2014.

What This Means for You

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. They cannot limit benefits for that condition either. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.

Life changes that can qualify you for a Special Enrollment Period

Changes in household

You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

• Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
• Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
• Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
• Died. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result, you’re no longer eligible for your current health plan.

Changes in residence

Household moves that qualify you for a Special Enrollment Period:

• Moving to a new home in a new ZIP code or county
• Moving to the U.S. from a foreign country or the United States territory
• If you’re a student, moving to or from the place you attend school
• If you’re a seasonal worker, moving to or from the place you both live and work
• Moving to or from a shelter or other transitional housing

Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.

Important: You must confirm you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide confirmation if you’re moving from a foreign country or U.S. territory.

Loss of health insurance

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.