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Important Message: Keep your address and other contact information up to date. Please check your information online or call us at 1-855-899-9600.
Please use this form to ask for an Exceptional Circumstances Special Enrollment Period (SEP). This SEP is used when specific things stopped you from enrolling during an enrollment period, such as Open Enrollment or a Special Enrollment Period. These include:
This Exceptional Circumstance SEP Request Form can’t be sent until you have completed an application for health coverage with Vermont Health Connect. If you have not completed an application, you can create an account and login to Vermont Health Connect’s secure online portal. Or, call our Customer Service Center at 1-855-899-9600 to apply. Below are some examples:
A Vermonter qualified for a Special Enrollment Period that expired March 31st. This person was in the hospital from March 14th to April 1st and was too sick to enroll in a QHP at that time. This person may be eligible for the Exceptional Circumstance SEP. They should complete the Exceptional Circumstances application, as well as the medical incapacity verification form.
A Vermonter qualified for a Special Enrollment Period that expired May 31st. This person got sick in July after their original SEP expired and now needs health coverage. This person was not sick during their original Special Enrollment Period and was not prevented from enrolling prior to May 31st. Therefore, this person would not qualify for the Exceptional Circumstance SEP.