Qualifying Life Events

Each year, Vermont Health Connect sets the dates for an open enrollment period (typically November 1 to January 15). If you miss open enrollment, only certain life events allow you to buy a plan or change your plan during other times of the year.

Special Enrollment Period

In most cases, you will have 60 days from the date of a qualifying life event to apply for a health plan through Vermont Health Connect (VHC) or through a parent’s employer’s group plan. This is called a Special Enrollment Period (SEP).

Qualifying life events

Qualifying life events include:

• getting pregnant
• getting married
• having a baby, adopting a child, or having a child placed in your home by a government agency
• moving to Vermont from another state
• losing other health coverage (for example, because of a job loss, divorce, loss of eligibility for Medicaid or Dr. Dynasaur, expiration of COBRA coverage, or a health plan being decertified)
  • Voluntarily quitting other health coverage or losing health coverage for not paying your premiums are not considered loss of coverage.
  • College students who involuntarily lose student health plans that meet the Minimum Essential Coverage that the Affordable Care Act requires are eligible for a special enrollment period (SEP). (See Student Health Plans and Penalties for more information.)

• having a change in income or household status that affects your eligibility for Medicaid or for tax credits or cost-sharing reductions (if you are already enrolled in a Medicaid or a Vermont Health Connect plan)
• becoming a U.S. citizen or becoming “lawfully present” in the U.S.
• losing your Medicaid at any time since March 2023
• if you have an income below 200% of the Federal Poverty Level, and you meet the requirements to get financial help, you can sign up or change your plan at any time during the year.

A medical event, like having a heart attack or being diagnosed with an illness, does not count as a qualifying life event.

You can find a full list of qualifying life events on the Vermont Health Connect website. The page also explains when the special enrollment time is for each kind of life event.

Exceptions

If you are a member of a federally recognized American Indian or Alaska Native tribe, you may enroll in or change plans one time per month.

In addition to the standard list of qualifying life events (above), special enrollment periods can be granted in some unusual situations. If you have an unusual situation, have a question or need to change an existing application, call Vermont Health Connect at 1-855-899-9600.