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Special Enrollment Period

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Do I qualify for this Special Enrollment Period? 

MN Residents only: February 16 - July 16

You can enroll in a plan if you’re currently uninsured, have a qualifying life event, or enrolled in a plan outside of MNsure. If you are currently enrolled through MNsure, savings will automatically be applied by MNsure, if qualifications are met, as early as May 1 for some populations.

Contact MNsure for more information and to see what savings you qualify for.

All other states: February 15 - August 15

If qualifications are met, you can make premium or plan changes to your current Marketplace plan. You can also enroll in a Marketplace plan if you’re currently uninsured.

Contact the Marketplace to see if you qualify for a $0 premium or any other savings.

Note: Any plan change you make during this Special Enrollment Period will reset your plan deductible and out-of-pocket maximum, unless otherwise directed by federal or state guidelines.

 

Qualifying Life Events

You may qualify to enroll through a Special Enrollment Period if one of the following applies to you.

If there was a change to your household or family structure, you may qualify for a Special Enrollment Period.

Examples include:

  • Getting married
  • Had a baby or adopted a child
  • Had a child placed for foster care
  • Getting divorced or legally separated and lost health insurance
  • Death in the family and lost health insurance as a result

If you permanently moved, you may qualify for a Special Enrollment Period.

Examples of qualified moves include:

  • Moving to a different ZIP code or county
  • Moving to the U.S. from another country
  • Student moving to or from the place they attend school

Note: In addition to moving, you also must prove you had qualifying health coverage for one or more days during the 60 days before your move.

If you or anyone in your household involuntarily lost their health coverage due to a policy subscriber moving to Medicare or employer-based coverage, you may qualify for a Special Enrollment Period.

Examples of involuntary loss of coverage include:

  • Losing employment-based health insurance
  • Losing individual health insurance
  • Losing eligibility for public insurance coverage such as Medicare, Medicaid or CHIP

Note: Voluntarily ending your health coverage or being terminated for not paying your premiums are not considered involuntary loss of coverage.

Other complicated or less common situations may also qualify you for a Special Enrollment Period.

Examples include:

  • Becoming a U.S. citizen
  • Released from prison
  • Experience a Marketplace enrollment error
  • Changes to your income that could make you eligible to enroll in a different type of coverage, either individual or a public insurance program like Medicaid or CHIP
  • Determined ineligible for Medicaid or CHIP

Your state's Health Insurance Marketplace will have a complete list.

Applying for Coverage

If you believe one of the life events above applies to you, here's what you need to know.

Shop your state's Health Insurance Marketplace
Shopping your state's Health Insurance Marketplace is the only way to determine if you're able to get help paying for your health plan. You'll also be able to get a quote and compare Medica plans that are available in your area.

Start shopping on the Marketplace
For  Iowa, Kansas, Missouri, Nebraska, North Dakota, Oklahoma, and Wisconsin residents

Start shopping on MNsure
For Minnesota residents


Not sure what to consider when choosing a plan? Learn how to be a smart shopper

No documentation beyond application completion is required to qualify for this Special Enrollment Period.

If your application is approved*, you’ll need to pay your first month premium for your coverage to activate. You can pay your premium:

On the Marketplace (HealthCare.gov) at the time of application (Not available to Minnesota residents)
This is the fastest way to ensure your first month payment is made and that your coverage will begin.

Using Medica's Payment Website
We offer a secure payment site to make your payment electronically with your checking/savings account.

Make an online payment >

Mail
If you prefer, complete this form (PDF) and return it with your payment (check or money order) to Medica. Make sure you mail it well in advance!

Medica
PO Box 856525
Minneapolis, MN 55485-6523 

  
*If applying through your state’s Health Insurance Marketplace, they’ll determine if you’re eligible to enroll through a Special Enrollment Period.

Here’s a quick summary of the materials you will receive from us so you can start using your benefits.

What Medica is doing:

Reviewing your application and setting up your policy.
We’ll contact you if we need more information.

Creating your ID card and welcome kit.
After you make your first month payment, you should receive these materials 7-10 days after we process your payment.

 


What you can do:

Explore your secure member site.
After you receive your ID card, register for your secure member site on medicamember.com.

Your secure member site is your one-stop resource for the information you need to manage your health plan benefits and help improve your health. It takes just a few minutes to register for the site. Register and you can:

  • View your ID card
  • See what’s covered by your plan, including important plan documents
  • Track your plan balances, such as your deductible and out-of-pocket maximum
  • Track your claims and explanations of benefits (EOBs)
  • Look up prices for prescriptions
  • Wellness tools and support
  • Check to see if a doctor or other health care provider is in your plan's network
  • Pay your premium
  • Sign up for automatic payment (automatic payments cannot be used for your binder payment)

 

Were Here to Help

There are several options for getting help.

Iowa, Kansas, Nebraska, North Dakota, Missouri, Oklahoma and Wisconsin Residents:
Call the Health Insurance Marketplace Call Center
1-800-318-2596 (TTY: 1-855-889-4325).
Available 24 hours a day, 7 days a week (except holidays)

Minnesota Residents:
Call MNsure’s Call Center
1-855-366-7873 (TTY: 711)
8 a.m. to 6 p.m. Central, Monday-Friday
10 a.m. to 2 p.m. Central, Saturday

If you work with a licensed agent or broker, they are your best resource for answering questions and helping you enroll in coverage.

Interested in working with an agent or broker? Find one near you.

Find an Agent >

You may work with one of our specially trained sales consultants.

Call
1-800-670-5935 (TTY: 711)
8 a.m. – 5 p.m. Central, Monday – Friday
(Closed 8 – 9 a.m. Fridays)

Email
MedicaIndividualProducts@medica.com

You may work with a certified application counselor, navigator, clinic or hospital-based financial counselor to answer your questions and help you enroll in coverage.

Iowa, Kansas, Nebraska, North Dakota, Missouri, Oklahoma and Wisconsin Residents:
Visit the Health Insurance Marketplace (HealthCare.gov) to find help in your area.
Find help >

Minnesota Residents:
Visit MNsure (MNsure.org) to find help in your area.
Find help >

Date: 4/13/2021 7:59:24 AM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB01