Survivors of Domestic Violence Can Now Get Access to Health Coverage Any Time

Female heath practitioner in hospital room

Today’s guest blogger is Lena O’Rourke, Founder and Principal of O’Rourke Health Policy Strategies,which is committed to developing and implementing good public policy on health care issues, with an eye toward making our nation’s health care system work.

UPDATE: On July 27, 2015, CMS released additional formal guidance about the Special Enrollment Period (SEP) for survivors of domestic violence and spousal abandonment.  The full guidance can be found here:

Of note, they expand the definition of who is eligible to receive the 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 ensures that unmarried partners, as well as dependent children or adults, are able to access this SEP if they are victims of abuse.

As of April 29, 2015, survivors of domestic violence may apply for health insurance through at ANY TIME. They do not need to wait for Open Enrollment. This new policy, which is strongly endorsed by FUTURES, allows survivors of domestic violence to qualify for a Special Enrollment Period—instead of the short window of time during Open Enrollment.

Access to high-quality, affordable health coverage can make a significant difference in the lives of survivors.

If at any point during the year, a survivor needs to purchase their health insurance, she should do the following:

  1. Call the Call Center at 1-800-318-2596. (It’s important that the applicant call rather than apply online, because this is the only way to qualify for a Special Enrollment Period.
  2. When speaking with the Call Center, be sure to use the phrase “survivor of domestic violence.” This will help them initiate the appropriate process.
  3. The Call Center will grant a Special Enrollment Period and the survivor will have 60 days to pick and enroll in a plan.

Some survivors will be eligible for financial assistance that will make health insurance much more affordable. There are specific rules for survivors who are still married but no longer living with their abuser. When applying, these survivors should mark “unmarried” on their application so that their eligibility determination will be based on their income (and not their spouses). No documentation is needed to prove domestic violence for the Special Enrollment Period or to receive the financial help. But self-attestation is required on tax forms the following year.  These policies are for all survivors of domestic violence—both women and men.

This policy change is an important victory for survivors of domestic violence, and the community of advocates, health care professionals, and service providers pushed for these changes. Access to high-quality, affordable health coverage can make a significant difference in the lives of survivors. No longer will survivors have to face going without health insurance until Open Enrollment. No longer will they have to choose to stay in an abusive relationship to be covered. This policy ensures that they are able to access coverage at any point during the year they need it, and that coverage is affordable.

For more information and details about this policy, please visit Health Cares About IPV.

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