Qualifying Life Event (QLE) - Health Insurance

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What is a Qualifying Life Event (QLE) in Health Insurance?

<lingo>A Qualifying Life Event, or QLE, is a change in your circumstances that may make you eligible to enroll in insurance outside of the Health Insurance Marketplace's annual Open Enrollment Period. The types of events that may qualify you for a Special Enrollment Period include losing your health insurance coverage, major changes in your household, changes in your residence, changes in income, or certain changes in status. Only certain events count as QLE, so it's important to confirm your eligibility through the Healthcare.gov QLE screening tool.</lingo>

Qualifying Life Event (QLE) Explained

The QLE circumstances that make you eligible for a Special Enrollment Period fall into four basic categories. First, a loss of your existing insurance, whether employer-sponsored, student or individual coverage; a loss of eligibility for Medicaid, Medicare or CHIP; or losing coverage under a parent's plan due to turning 26. 

 

<twitter>A Qualifying Life Event, or QLE, is a change in your circumstances that may make you eligible to enroll in insurance outside of the Health Insurance Marketplace's annual Open Enrollment Period. </twitter>

 

 

The second QLE category includes household changes such as getting married, getting divorced, having or adopting a child, or a death in the family. The third QLE category includes changes in residence caused by moving to a different county or zip code, moving to attend school, seasonal work, or moving to a shelter or other transitional housing.

 

Finally, qualifying life events may include changes in income, ‚Äčleaving jail or prison, and starting or ending AmeriCorps service. Becoming a U.S. citizen or gaining member in a Native American or Alaskan tribe may also count as a QLE. 

 

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