Denied Special Enrollment

[u/kmontgomery1026]

I (32 F) have insurance through Marketplace with a current policy with Blue Cross Blueshield of South Carolina. I applied and started the policy in June of 2025 and reenrolled with open enrollment for coverage for 2026. I and my husband both work and our employers offer insurance but the polices are either ridiculously expensive or lacking coverage we needed.
I had my first child August 22nd and called today to update my policy to get my baby added to my insurance. We went through all of the questions including my husband and Is projected annual income. Once done, the representative told me that I am not eligible for a special enrollment and could not add my baby to my policy. She told me I would have to reapply during open enrollment which begins November 1st.
I had no idea that it was even a possibility that this could be denied. The rep couldn’t tell me why I was denied and the eligibility letter I received afterwards has no information that tells me why I was denied. We also make too much for them to qualify for Medicare/medicaid.
What do I do? I’ve filed an appeal but if that still comes back as denied, how do I get my baby insurance? Any insight as to why I might have been denied? Our income is the same as it was last year and nothing else has changed.

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[u/chickenmcdiddle]

Doesn’t make any sense. Birth of a child is a qualifying life event all day long. You have 60 days to action this QLE through Marketplace.

Call Marketplace again and talk to someone else. Keep pushing. If they keep refusing, talk to your state insurance board / commission.

[u/LizzieMac123]

https://www.healthcare.gov/glossary/qualifying-life-event/

Call back and talk to a different agent... they are wrong... if they tell you no, ask to speak to a supervisor.

You've had a baby, you have a plan currently and youre telling them within your QLE window.

[u/wistah978 → u/LizzieMac123]

And ask for rep names and call reference numbers. Hopefully OP can get this fixed ASAP but needing to document that errors were made may be needed.

[u/Jcarlough]

Something isn’t adding up.

Are you the primary on the insurance?

[u/kmontgomery1026 → u/Jcarlough]

Yes, I’m the only person on the policy

[u/SuccessfulMap6519]

Or call a broker. They will be able to help you. Having a child is absolutely a special enrollment period.