Do you qualify for the Special Enrollment Period?
If you qualify for a Special Enrollment Period, you can enroll in health insurance outside the annual Open Enrollment period.
You qualify for a Special Enrollment Period (SEP) if you’ve had certain life changes like getting married, having a baby, or losing job-based health insurance. These are called “qualifying life events.”
You can qualify for a special enrollment period if any of the following applies to you:
- Coverage can take effect: The first day of the month after you enroll
- Enrollment window: Up to 60 days after your marriage. (You can’t enroll until after the marriage.)
Having a Child
- Having a baby, adopting a child, or placing a child for adoption
- Coverage can take effect: The day of the event
- Enrollment window: Up to 60 days after the event
Turning 26 Years Old
- Aging off a parent’s coverage at 26
Losing Current Health Care Coverage
- This could include losing a job-based plan, losing coverage through divorce, losing eligibility for Medicaid or CHIP, and similar events:
- Coverage can take effect: The first day of the month after you enroll and after the loss of coverage
- Enrollment window: From 60 days before to 60 days after losing your other coverage Important: If you leave your job for any reason and lose your job-based health coverage, you qualify for a Special Enrollment Period. But you don’t get an SEP if you voluntarily drop: a job-based plan without leaving your job; an individual insurance plan; unexpired COBRA coverage; or any plan that doesn’t qualify as minimum essential coverage.
Other qualifying life events
In addition to the situations above, the following life events also qualify you for a Special Enrollment Period. But if they happen during Open Enrollment, your coverage can’t start any sooner than it would without an SEP.
- Moving your residence outside your insurance plan’s service area
- Gaining citizenship
- Gaining status as member of a federally recognized tribe or shareholder in an Alaska Native Claims Settlement Act (ANCSA) Corporation. Members of federally recognized Indian tribes can enroll in or change plans once a month throughout the year.
- Leaving incarceration
- For people already enrolled in Marketplace coverage: Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions.
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