Qualifying Life Events for Health Insurance in Wisconsin

  • July 09, 2017
  • |Quartz
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One of the most common qualifying events for health insurance in Wisconsin is changes in household size.

The Affordable Care Act (ACA) has changed a lot of things about health insurance. One of the changes people are still getting used to is the fact that you can’t get health insurance any time you want it. You can only buy it during Open Enrollment – unless you have a qualifying event for health insurance. Then you get access to a Special Enrollment Period (SEP).

The government is very specific about what counts as a health insurance qualifying event.

A qualifying event for health insurance is –

  • Changes in household size (marriage, divorce, birth, adoption or death that results in loss of coverage)
  • Moving
  • Special circumstances

In 2015, three-fourths of those who had qualifying events for health insurance1 provided one of these reasons –

  • Loss of minimum essential coverage
  • Permanent move
  • Birth
  • Adoption, placement for adoption, placement for foster care or child support or other court order
  • Marriage

New Requirements for Health Insurance Qualifying Events

Unfortunately, some of those who used SEPs in the past did not actually have a qualifying event for health insurance. Because of this, people now have to prove when they have a health insurance qualifying event. The government looks very closely at these applications and may ask for more information. Those who don’t provide accurate information risk penalties and losing their coverage.


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