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By Ryan Kennelly

May 5, 2017

Topics:

  • Individual & Family Health Insurance
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I’m getting married but neither of us have health insurance. Do we qualify for an SEP after we get married?

May 5, 2017

  • Individual & Family Health Insurance

As of June 19, 2017, to qualify for an SEP due to a marriage, at least one spouse must have:

  • Had qualifying coverage OR
  • Lived in a foreign country or in a U.S. territory for one or more days during the 60 days preceding the date of the marriage.

This prior coverage requirement does not apply to members of a federally recognized tribe or shareholders of Alaska Native Corporations (sometimes referred to as “AI/AN”).

Example: Bob and Britney got married on May 5th.

Since Britney was already enrolled in a Marketplace plan:

  • Bob can join her plan
  • Bob can enroll in a different plan
  • Britney can enroll in a different plan with Bob

They can report their marriage and pick a Marketplace plan up to 60 days after May 5th. Their coverage will start based on accelerated prospective coverage effective dates – the first of the month after they choose a plan, regardless of when during the month they select their plan. For example, if they pick a plan on May 18, their coverage will start on June 1.

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