West Virginia Health Insurance Special Enrollment Periods (SEP)

Open Enrollment for 2014 Marketplace coverage ended on March 31st, 2014. Outside of the normal Open Enrollment period, you can enroll in a private health plan through the Marketplace only if you qualify for a special enrollment period.  Below is helpful information, mainly gathered from Healthcare.gov, that can help you better understand if you may qualify for a special enrollment period.

Please contact our office for more information at (304) 720-5641 or send us a request for help here.

You can qualify for a special enrollment period if either of the following applies to you:

  • You have a qualifying life event such as having a child, getting married, or losing other health insurance coverage. Contact us to learn more about special enrollment periods.
  • You have other complicated situations, as described on this page.

Other complicated situations that may qualify for a special enrollment period

Below are cases and examples that may also qualify you for a special enrollment period.

Exceptional circumstance

You faced a serious medical condition or natural disaster that kept you from enrolling. For example:

  • An unexpected hospitalization or temporary cognitive disability
  • A natural disaster, such as an earthquake, massive flooding, or hurricane

Misinformation or misrepresentation

Misconduct by a non-Marketplace enrollment assister (like an insurance company, navigator, certified application counselor, or another agent or broker) resulted in you:

  • Not getting enrolled in a plan
  • Being enrolled in the wrong plan
  • Not getting the premium tax credit or cost-sharing reduction you were eligible for

Enrollment error

The insurance company was unable to process your enrollment because of a technical error between the Marketplace and the insurance company.

System errors related to immigration status

An error in the processing of applications or system caused you to get an incorrect immigration eligibility result when you tried to apply for coverage.

Display errors on HealthCare.gov

Incorrect plan data was displayed at the time that you selected your health plan, such as benefit or cost-sharing information. This includes issues where some consumers were allowed to enroll in plans offered in a different area, or enroll in plans that don’t allow certain categories of family relationships to enroll together.

Medicaid/Marketplace transfers

  • If you applied for Medicaid through your state, or were sent to Medicaid from the Marketplace, but you weren’t eligible for Medicaid.
  • Your state transferred your information to the Marketplace but you didn’t get an answer about your eligibility and/or didn’t get enrolled before March 31.

Error messages

Your application was stopped due to specific error messages. For example, you received a “data sources down” error message or another error message that didn’t allow you to enroll.

Unresolved casework

You’re working with a caseworker on an enrollment issue that didn’t get resolved before March 31.

Victims of domestic abuse

You’re a victim of domestic abuse and weren’t previously allowed to enroll and receive advance payments of the premium tax credit separately from your spouse. You’ll be able to do so now.

Other system errors

Other system errors that kept you from enrolling, as determined by the Centers for Medicare & Medicaid Services