Blue Access for Members
Individual & Family:

How Do I Apply for Special Enrollment With BCBSTX?

If you go through a life event that qualifies you for Special Enrollment, you can update or choose a new plan. You normally have 60 days after your life event to pick a plan.

Visit our shopping platform to compare coverage options and their prices. Once you've found the right plan, enroll and make your first premium payment.

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How Do I Know if I'm Eligible for Special Enrollment?

If you go through a "qualifying life event," you're eligible for Special Enrollment. Learn more about some common life events:

Some common changes in your family that qualify you for Special Enrollment are:

  • Having or adopting a child, or gaining a dependent through court-order
  • The passing of a policy holder
  • Getting married, or establishing a Civil Union or domestic partnership
  • Separating or divorcing your spouse 

Some common residential changes that qualify you for Special Enrollment are:

  • Moving to a new area with different plans or HMO network
  • Moving to or from a place you attend school, live or work as a seasonal worker or live in for transitional or shelter housing
  • Relocating to Texas from another state

 

Some common reasons for losing coverage that qualify you for Special Enrollment are:

Some common changes to your job or income that qualify you for Special Enrollment are:

  • Losing or changing your job or losing COBRA coverage

  • A change in income or household status

  • An employer offering to help with your coverage cost (through an ICHRA  or QSEHRA)

  • Having an annual individual or household income at or below 150% of the federal poverty level 

Some other life events that qualify you for Special Enrollment are:

  • Your health care coverage ending on a date other than December 31st of the current plan year

  • Becoming a U.S. citizen

  • A health insurance company violating its contract with you

  • Becoming a member of an American Indian or Alaska Native tribe

  • Experiencing an error or other issue when trying to enroll

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Can I Use Special Enrollment to Switch to a Better Plan?

Sometimes, a life change means a change in your needs. Special Enrollment is the perfect chance to update your plan to coverage that better fits your needs:

  • Choose a plan with lower costs
  • Explore plans with different benefits
  • Add a dependent or a spouse to your coverage

Do I Need to Show Proof of My Event or Insurance Coverage?

Depending on your life event, you may need to submit some documentation.
These documents normally fall into 1 of 2 categories:

1. Proof of your life event.

These documents show when your life event was. A few examples are:

  • A marriage license
  • A birth certificate
  • A letter from your employer

2. Proof that you had insurance.

Depending on the documents you submit, you may also need to send proof of insurance like a:

  • Letter from your insurer
  • Printout from a benefits administration website
  • Certificate of Credible Coverage

What Happens If I Miss My Special Enrollment Deadline?

Can I still get insurance?

You normally have 60 days after your life event to enroll through Special Enrollment. If you miss that deadline, you may have to wait until Open Enrollment, beginning November 1.

You can also check if you qualify for Medicare or Medicaid plans. These plans are offered by the government. Eligibility is based on age, income or disability.

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Additional Questions