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Fact Sheet
June 2016

Acceptable Documentation for Special Enrollment Periods

Please note:

  • Consumers applying for the SEP following a permanent move will need to provide proof of BOTH their old address and their new address. If a consumer’s documentation fails to list both the new and old address, they will be required to submit two documents to confirm eligibility.
  • Consumers applying for SEPs following the loss of minimum essential coverage (MEC) or a permanent move SEP are able to provide a letter of explanation when documentation is not available. For guidance on what should be included in these letters, consumers should look at their eligibility determination notice or seek the help of an in-person assister in their area.

Outside of open enrollment, consumers still have the opportunity to enroll in qualified health plans when they experience certain life changes, such as marriage or a permanent move to an area with new coverage options. These opportunities to enroll outside of open enrollment are called special enrollment periods, or SEPs. As of June 17, 2016, consumers enrolling through five of the most common SEPs, in the 38 states using the Healthcare.gov platform, are required to provide documentation to the marketplace to prove they are experiencing a life change that qualifies them for a SEP.

The five SEPs that require consumers to provide documentation are:

  1. Marriage
  2. Birth
  3. Adoption
  4. Loss of minimum essential coverage (MEC)
  5. Permanent move

Below is a chart that outlines the types of documents that consumers can submit to the marketplace to prove their eligibility for an SEP. These documents must be provided to the marketplace within the time frame outlined in the notice that the consumer receives after applying for coverage. Use this chart as a helpful guide to which types of documents are acceptable proof for the marketplace.

Most consumers only need to provide ONE piece of documentation in the confirmation process. See the "Please note" sidebar for an exception regarding the SEP for people who have moved.

If you got married:

Marriage certificate showing the date of the marriage Marriage license showing the date of the marriage
An official public record of the marriage, including a foreign record of marriage Affidavit or statement signed by the person who officiated the marriage
Affidavit or statement signed by a person who was an official witness to the marriage A religious document that recognizes the marriage

If you adopted a child:

Adoption letter or record showing date of adoption dated and signed by a court official Government-issued or legal document showing the date that the child was placed in the home
Government-issued or legal document showing the date legal guardianship was established Court order showing the effective date of the order
U.S. Department of Homeland Security immigration document for foreign adoptions Medical support order
Foster care papers dated and signed by a court official  

If you had a child:

Medical record from a clinic, hospital, physician, midwife, institution, or other medical provider showing the date of birth Letter from hospital, clinic, physician, or other medical provider attesting the date of birth
Letter or other document from the health insurance company, like an Explanation of Benefits, showing that services related to birth or post-birth care were provided to either the child or the mother, including the dates of service Birth certificate or application for a birth certificate for the child
Application for a Social Security Number (SSN) for the child A foreign birth record showing the child’s date and place of birth
Military record showing the child’s date and place of birth Religious record showing the child’s date and place of birth
Social Security card for the child  

If you lost minimum essential coverage (MEC):

Letter or other document from an employer stating that the employer dropped or will drop coverage or benefits for the employee or employee’s spouse or dependent family member, including the date coverage ended or will end Letter or other document from an employer stating that the employer stopped or will stop contributing to the cost of coverage
Letter or other document from an employer stating that the employer changed or will change coverage or benefits for the employee, or for the employee’s spouse or dependent family member, so it’s no longer considered qualifying health coverage Letter showing an employer’s offer of COBRA coverage, or stating when the employee’s COBRA coverage ended or will end
Letter from health insurance company showing a coverage termination date, including a COBRA coverage termination date Proof that you had qualifying health coverage within the last 60 days, like a pay stub showing deductions for health insurance
Letter from school stating when student health coverage ended or will end Letter or notice from Medicaid or the Children’s Health Insurance Program (CHIP) stating when Medicaid or CHIP coverage ended or will end
Letter or notice from a government program, like TRICARE, Peace Corps, AmeriCorps, or Medicare, stating when that coverage ended or will end Dated copy of military discharge papers or Certificate of Release including the date that coverage ended or will end, if you’re losing coverage because you’re no longer active duty military
Divorce or annulment papers that include the date of ending responsibility for providing health coverage Death certificate or public notice of death that includes proof of the date that you lost or will lose coverage due to the death of a spouse or other family member
Dated and signed copy of written verification from an agent or dated letter from the issuer, if you are or were enrolled in a non-calendar year plan that’s ending Copy of pay stubs of both current and previous hours if a reduction in work hours caused you to lose coverage
Letter of explanation about the coverage you had, why and when you lost or will lose it, and the reason you can’t provide any other documents proving you’re eligible for a Special Enrollment Period. The Marketplace will take your letter into consideration.  

If you moved:

Lease or rental agreement Insurance documents, like homeowner’s, renter’s, or life insurance policy or statement
Mortgage deed, if it states that the owner uses the property as the primary residence Mortgage or rental payment receipt
Mail from the Department of Motor Vehicles, like a driver’s license, vehicle registration, or change of address card State ID
Official school documents, including school enrollment, ID cards, report cards, or housing documentation Internet, cable, or other utility bill (including any public utility like a gas or water bill) or other confirmation of service (including a utility hook up or work order)
Telephone bill showing your address (cell phone or wireless bills are acceptable) Mail from a government agency to your address, like a Social Security statement, or a notice from TANF or SNAP agency
Mail from a financial institution, like a bank statement U.S. Postal Service change of address confirmation letter
Pay stub showing your address Letter from a current or future employer showing you relocated for work
Voter registration card showing your name and address Moving company contract or receipt showing your address
If you’re living in the home of another person, like a family member, friend, or roommate, you may send a letter/statement from that person stating that you live with them and aren’t just temporarily visiting. This person must prove their own residency by including one of the documents listed above. Document from the Department of Corrections, jail, or prison indicating recent release or parole, including an order of parole, order of release, or an address certification
If you’re homeless or in transitional housing, you may submit a letter or statement from another resident of the same state, stating that they know where you live and can verify that you live in the area and aren’t just temporarily visiting. This person must prove their own residency by including one of the documents listed above. Letter from a local non-profit social services provider or government entity (including a shelter) that can verify that you live in the area and aren’t just visiting.
Naturalization Papers signed and dated within the last 60 days or Green Card, Education Certificate, or VISA (if you moved to the U.S. from another country) Letter of explanation providing the date of your move, your old and new address (or where you’re staying), and the reason you can’t provide any other documents proving you’re eligible for a Special Enrollment Period. The Marketplace will take your letter into consideration.