Major life events can change your eligibility for healthcare programs and financial help through Vermont Health Connect. For example, a major life event could mean that you:
- Are newly eligible for Medicaid or Dr. Dynasaur coverage
- Are newly eligible to get financial help, such as premium tax credits
- Can add new family members to your healthcare plan
- Have a change to the amount of financial help you can get
If you get financial help from Vermont Health Connect and you forget to report a change, you might end up owing money back to the federal government when you file taxes. That’s one reason why it’s important to report any major life changes to Vermont Health Connect within 30 days after the change happens.
If you’ve had a major life event, you may be eligible for a Special Enrollment Period (SEP) to enroll in Vermont Health Connect coverage. A Special Enrollment period lets you sign up for coverage or change the plan you already have. This is the only time you can sign up for new coverage or change coverage outside of Vermont Health Connect’s Open Enrollment Period which typically runs from November 1-December 15 every year. But don’t delay! Special Enrollment Periods usually give you 60 days to sign up for coverage. If you miss it, you may have to wait until Open Enrollment to get coverage.
Medicaid and Dr. Dynasaur enrollment continues year-round. Vermonters who are eligible for these programs can enroll at any time. If you are enrolled in Medicaid you must report any changes within ten days.
For a detailed list of major life events and Special Enrollment periods, check out our qualifying events chart.
In addition to our standard qualifying events, special enrollment periods can be granted under additional exceptional circumstances. Vermonters should apply for the Exceptional Circumstance SEP only if an event such as a medical issue, natural disaster, or a system interruption prevented them from enrolling in a QHP during their enrollment period (like Open Enrollment or a Special Enrollment Period). 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.
Apply for an Exceptional Circumstances SEP here. If you have a question about an exceptional circumstance, or need to change an existing application, please call 1-855-899-9600.