When you are enrolled through the Marketplace, it is important to report life changes. Even if you think it is insignificant, you should report all changes to ensure you are getting the most accurate financial assistance and are still enrolled in the best plan.
- Changes you should report to the Marketplace are:
- Moving
- Losing health coverage (including the Oregon Health Plan)
- Gaining other health coverage like job-based coverage, OHP, or Medicare
- Changes in household:
- Marriage
- Gaining or losing a dependent
- A child on your plan turning 26
- Divorce
- Death
- Changes to expected income
- Changes to name
- Changes in status
- Disability status
- Tax filing status
- Citizenship or immigration status
- Status as an American Indian, Alaska Native, or tribal member
- Incarceration or release from incarceration
Report life changes to the Marketplace right away. You may qualify for a special enrollment period to enroll in or change plans mid-year. If you do, you will have only 60 days from the date of the event to enroll. There are three ways to report a life change:
- Log in to your account on HealthCare.gov and select your current application. Select “Report a life change" in the menu on the left.
- Contact the insurance agent or community partner who assisted you with your enrollment.
- Call HealthCare.gov directly at 800-318-2596 (toll-free).
After reporting your life change HealthCare.gov will recalculate your eligibility for coverage and financial assistance. You may receive more or fewer tax credits for the rest of the year. You can adjust the amount of tax credits that you are using per month according to the recalculation. You may also be newly eligible for extra savings on out-of-pocket costs such as co-insurance, co-payments, and deductibles. If your eligibility for these extra savings changes, or you become newly eligible for financial assistance altogether, you can change your plan within 60 days of the event.
NOTE: If you are found to be potentially eligible for the Oregon Health Plan (OHP), your information will be sent to the Oregon Health Authority for processing. If you are deemed eligible, you must report the new coverage to HealthCare.gov and cancel your plan through the Marketplace. If you do not, you may be responsible to pay back all financial assistance received while you also had OHP coverage. Do not cancel your coverage before the Oregon Health Authority notifies you that you are enrolled in OHP coverage. You can not re-enroll through HealthCare.gov if you cancel your health coverage too soon.
HealthCare.gov will provide you with a new eligibility notice. Carefully read this notice. The notice will explain any changes to your eligibility and whether you qualify for a special enrollment period. The notice may also tell you that you need to submit supporting documents.
You may qualify for a special enrollment period, which allows you to shop for a new plan through HealthCare.gov. You will be offered the chance to enroll in coverage or change your coverage after you read your eligibility notice. You can also access this section by logging in to HealthCare.gov, selecting the current application, then selecting “Eligibility and appeals" in the menu on the left. You will then see an option to “Continue to enrollment." The insurance agent or community partner organization who helped you enroll in health coverage can also help you change plans.
If you are not eligible for a special enrollment period, but the amount of tax credits you qualify for has changed, you cannot change plans. You can adjust the amount of tax credits to apply to your monthly premium.