Could You Qualify For A Special Enrollment Period?
The Special Enrollment Period (SEP) refers to a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You could qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.
Life changes that can qualify you for a Special Enrollment Period:
Changes in household
You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:
Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
Died. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result, you’re no longer eligible for your current health plan.
Changes in residence
Household moves that qualify you for a Special Enrollment Period:
Moving to a new home in a new ZIP code or county
Moving to the U.S. from a foreign country or a United States territory
If you're a student, moving to or from the place you attend school
If you're a seasonal worker, moving to or from the place you both live and work
Moving to or from a shelter or other transitional housing
Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.
Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don't need to provide proof if you’re moving from a foreign country or a United States territory.
Loss of health insurance
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days (or more than 60 days ago but since January 1, 2020) OR expects to lose coverage in the next 60 days.
Important: If you lost coverage more than 60 days ago, but since January 1, 2020, and didn’t enroll sooner because you were impacted by the COVID-19 emergency declared by FEMA, you may still qualify for a Special Enrollment Period.
More qualifying changes
Other life circumstances that may qualify you for a Special Enrollment Period:
Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
Leaving incarceration
Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
Your special enrollment period for individual market coverage applies both on and off the exchange, but if you’re eligible for subsidies, you’ll need to get your plan through the exchange. Our team at RCB & Associates can help you determine your options.
Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the event to enroll in a plan. If you miss your Special Enrollment Period window, you may have to wait until the next Open Enrollment Period to apply.
