Domestic Violence and ACA Enrollment

Victims of Domestic Violence Eligible for ACA Enrollment throughout Year

Victims of domestic violence and spousal abandonment are eligible to apply for health insurance at any point during the year as opposed to open enrollment windows. This Special Enrollment Period (SEP) is not widely known and has been in effect since 2015. Previously, the eligibility requirements and open window for this SEP were more restrictive. In 2015, the Centers for Medicare & Medicaid Services (CMS) released formal guidance that expanded the definition of who is eligible to receive this SEP to “any member of the household who is a victim of domestic abuse including unmarried and dependent victims within the household, and including spousal abandonment and their dependents”.

This decision allows unmarried partners, as well as dependent children or adults, to access this SEP if they are victims of abuse. This SEP is valid for 60 days following an eligible individual’s request in which they may apply for, and enroll in, coverage for him or herself and dependents through the Federally-facilitated Marketplace. This SEP is available to both men and women, and no documentation is needed to prove domestic violence. However, the individual must attest to domestic violence on his or her tax forms in the following year.

Domestic violence survivors should do the following if they need health insurance:

Applicants using this SEP may be eligible for health care subsidies. The call center can assist with the completion of the application and answer questions about subsidy eligiblity and completion of tax forms for the year in which the applicant recieved the SEP.