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Frequently Asked Questions (FAQs)

Are there exceptional circumstances that would make me eligible for a special enrollment period?

Yes. Individuals and families may qualify to select a new plan or enroll in a plan for the first time after the annual open enrollment period ends if they experience one of the following exceptional circumstances:

  • You could not enroll during the open enrollment period or a special enrollment period for one of the following reasons:
    • A natural disaster such as an earthquake, massive flooding, or hurricane
    • A serious medical condition such as an unexpected hospitalization or temporary cognitive disability
    • A DC Health Link system outage around the plan selection deadline
    • Your employer applied to enroll you in coverage through DC Health Link’s Small Business (SHOP) marketplace, but was ultimately denied because too few employees selected the coverage
  • You were automatically enrolled in a different insurance plan than the one you had last year
  • Losing access to employer-sponsored coverage, COBRA, or another group health coverage because the employer responsible for submitting a portion (or all) of your premiums fails to submit them on time
  • Losing access to health coverage provided by an employer due to the employee becoming eligible for Medicare
  • Losing eligibility for an exemption from the individual mandate penalty
  • Starting or concluding service as an AmeriCorps State and Local, NCCC, or VISTA volunteer

If you experience an exceptional circumstance, your special enrollment period will last for 60 days from the date of the event. If you wait more than 60 days to request the special enrollment period, your request may be denied. If one or more of these situations apply to you, please call DC Health Link at (855) 532-5465.

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