Qualifying Life Events under the Pennsylvania Pennie Program

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Qualifying Life Events (QLEs) are situations where individuals or families may qualify for immediate enrollment in health insurance through the Pennsylvania Pennie Health Insurance Marketplace. Understanding what Qualifying Life Events trigger a QLE helps you understand when you can apply for new coverage.

Open enrollment for Pennie is November 1 2022 through Jan 15 2023 but special enrollment periods exist for people with Qualifying Life Events – this includes losing your current health insurance, losing eligibility for Medicaid, losing parental coverage, moving to a new zip code, having a baby, death in the family, getting married or divorced, significant income changes, and several other scenarios. If you’ve recently had a qualifying life event, you are eligible to get new coverage right away.

Most of the time you have 60 days after a Qualifying Life Event to report your QLE and enroll in new coverage.

There are four basic kinds of Qualifying Life Events:

  1. Loss of health coverage – this can be job-related, eligibility for Medicaid, CHIP, or Medicare, or turning 26 and losing family coverage.
  2. Changes in household – getting married or divorced, having a baby, adoption, or death in the family.
  3. Changes in residence – moving to a new zip code or county within Pennsylvania, move to Pennsylvania from out of state, student move, seasonal working arrangement, or moving from a shelter
  4. Other events – significant changes in income, gaining immigration status, leaving incarceration, AmeriCorps members starting or ending service.

There are also other QLE events. Some QLEs need to be verified by Pennie. For more information on submitting documentation for a QLE, you can visit the Pennie site.

Qualifying Life Events can be tricky to navigate. If you have questions or don’t know where to start, we can guide you through the process and help you review your QLE status and submit your information to Pennie. Fill out this form or give us a call at (570) 253-0466 to talk to a coverage specialist – we’re here to help.

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