Special Enrollment Period checklist

A Special Enrollment Period (SEP) is a designated time outside the annual Open Enrollment Period when you can sign up for health coverage. This period is triggered by specific life events known as qualifying life events (QLEs).

Identify your QLE

QLEs are significant changes in your life that allow you to enroll in or change your health insurance plan. QLE's include:

 

Certain situations do not qualify for an SEP, such as:

• Canceling health coverage: Voluntarily canceling your health insurance
• Not paying premium: Losing coverage because you didn't pay your premiums

Gather required documentation

To confirm your QLE, you may need to submit specific documents before your coverage can begin. Examples of required documentation include:

• Marriage certificate
• Birth or adoption certificate
• Letter from your employer
• Proof of new address
• Other relevant documents

Having these on hand will help streamline your enrollment and ensure timely access to your health coverage. Not all applications or QLEs require documentation. If necessary, you will receive an email with instructions on how to submit the documents.

Understand the SEP timeframe

In most circumstances, you have up to 60 days before or 60 days after your QLE to enroll in health coverage.

Research health plans

When selecting a health plan, it's crucial to look beyond just the premium costs. The lowest premium might not always be the most cost-effective option in the long run. Consider other important factors like deductibles, co-pays, and coverage benefits to ensure your plan meets both your financial and health care needs.

MyPriority^® health plans offer a range of valuable benefits, including:

• $0 preventive care: Services like annual physical exams, immunizations, and certain cancer screenings are fully covered before your deductible is met.
• On-demand mental health support: Access Teladoc Health Mental Health for help with stress, anxiety, chronic pain, and more. This service is available at no cost, and can be self-directed or with coaching support.
• Chronic condition management: Services, supplies, and prescriptions for common long-term health conditions are covered with cost share or in full before your deductible is met.
• Diabetes management: Essential supplies, treatments, prescriptions, and tests for diabetes are covered with cost share or in full before your deductible is met.
• Low prescription costs: Use the PriceMyMeds app to ensure you pay the lowest price available for your prescriptions.
• Cost Estimator: Powered by Healthcare Bluebook, this tool provides cost estimates for health care services based on your plan, helping you get the best care at the best price.
• Network and access: MyPriority members have access to a large network of high-quality primary care providers across Michigan, along with virtual urgent and primary care options for convenient access to care.
• Award-winning customer service¹: Michigan-based enrollment specialists are available to answer your questions, provide quotes, and assist with enrollment.

Need help researching plans? Take our plan quiz, where you can discover which MyPriority plan is right for you.

Check if you qualify for savings

You might be eligible for subsidies that make your health coverage more affordable. Priority Health offers a free subsidies guide that explains the various types of subsidies, how they can lower your plan costs, and how to determine if you qualify.

You can also check your eligibility when you get a free quote online or by speaking with an enrollment specialist.

Enroll in a health plan

You have several ways to enroll during a Special Enrollment Period (SEP).

• Online: Shop Mypriority Individual and family plans
• Call an enrollment specialist: Get personalized assistance from a Michigan-based enrollment specialist who can guide you through the enrollment process

Confirm your coverage start date

During SEP, your new health plan typically starts on the first day of the month following the month you enroll, meaning if you select a plan mid-month, your coverage will begin the first day of the next month. For certain qualifying life events, coverage could start the next day or retroactively to the date of the event itself.

Pay your first premium

Before you can use your plan, you must complete the final enrollment step, making your first premium payment. This initial payment, known as the binder payment, secures your health coverage and is usually the cost of your first month's premium.

The deadline for this payment can vary depending on your policy and enrollment details. It's crucial to check your policy documents to know when your binder payment is due. Typically, you'll receive this deadline when you enroll or shortly after.

Making this payment on time is essential to keeping your coverage active and avoiding any delays in accessing your health benefits.

Have questions?

Our Michigan-based enrollment specialists are here to help.

Explore Priority Health plans today to find the best option for you. Our team is ready to assist you every step of the way, ensuring a smooth and easy enrollment process. Don't miss out on securing the health coverage you need.