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Special enrollment

Special Enrollment is a period of time outside of the Open Enrollment period during which you may be eligible to apply for an individual or family health plan. If you experience a qualifying life event, such as getting married, having or adopting a baby, losing your coverage, or permanently moving into a new service area, you may be able to apply during the Special Enrollment period (SEP).

Low income SEP

Under the American Rescue Plan, an SEP is now available for Pennsylvanians with income levels between 138% – 149% of the federal poverty level (FPL). For reference, please see the chart below to see if you qualify.

Who needs coverage? What is the income for those covered under the health plan?
Single person $17,774.40 – $19,319.99
Family of 2 $24,039.60 – $26,129.99
Family of 3 $30,304.80 – $32,939.99
Family of 4 $36,570.00 – $39,749.99
Family of 5 $42,835.20 – $46,559.99
Family of 6 $49,100.40 – $53,369.99
Family of 7 $55,365.60 – $60,179.99
Family of 81 $61,630.80 – $66,989.99

See if you qualify.

Outside of Open Enrollment, here’s how to apply if you qualify for a SEP:

When can I enroll during a Special Enrollment period?

A Special Enrollment period occurs if you have a qualifying life event. In most cases, you will have 60 days after the qualifying life event to enroll in or make changes to a health plan.

Certain life events, like moving into the Independence Blue Cross coverage area, allow you to apply for a health plan up to 60 days before a qualifying life event. If you are losing health care coverage provided by an employer, you will have up to 60 days before and after this qualifying life event to enroll in a health plan.

When you apply for a Special Enrollment period for the following qualifying life events, you will be sent an Eligibility Notice for Coverage.

This notice will include a list of acceptable documents you may provide to prove your eligibility for the Special Enrollment period. Please provide these documents by the deadline listed in the notice to avoid disruptions to your health care coverage. You must send the documents before you can start using your health care coverage.

How to apply during a Special Enrollment period

1 For more than eight, add this amount for each additional person: $4,480.