Special Enrollment Periods

When the Open Enrollment Period for the year is over, you can only enroll in or change a health plan if you qualify for a Special Enrollment Period.

Typically, a consumer has 60 days (about 2 months) after experiencing a qualifying event to apply for coverage. Use this tool to see if you qualify: or contact a Navigator at 866-826-8375.

Qualifying Special Enrollment Events

There are many events that trigger a special enrollment opportunity, such as:

• Loss of minimum essential coverage or other qualifying coverage (i.e., loss of employee-based coverage, Medicaid or CHIP, or coverage after a divorce)
• Marriage (if one or both spouses had other qualifying coverage or minimum essential coverage for at least one day during the 60 days prior to the marriage)
• Gaining a dependent (through foster care, adoption, or court order)
• Aging off a parent’s plan at 26 years or other loss of Dependent status
• Moving to another state
• Change in immigration status from a non-eligible status to an eligible one
• Leaving incarceration

Populations That Qualify Throughout The Year

Some populations are also able to enroll throughout the year without experiencing events, such as:

• Consumers who are American Indian or Alaska Natives can enroll or change their marketplace plan one time per month. More information can be found at https://www.healthcare.gov/american-indians-alaska-natives/
• If you’re a survivor of domestic abuse/violence or spousal abandonment and want to enroll in your own health plan separate from your abuser or abandoner, contact a Navigator. Your dependents may be eligible too. If you’re married to your abuser/abandoner, you can answer on your Marketplace application that you’re unmarried, without fear of penalty for misstating your marital status. You then become eligible for a premium tax credit and other savings on a Marketplace plan, if you qualify based on your income. If you qualify for this SEP, you’ll have 60 days to enroll in a Marketplace plan.

Documents For Enrollment Applications

If you qualify for a Special Enrollment Period and apply for Marketplace coverage, you may be asked to provide documents to confirm the events that make you eligible.

• You’ll learn if you must provide documents after you submit your application. Details and instructions will appear on your eligibility notice.
• It’s best to pick a plan first and submit your documents afterwards. After you pick a plan, you have 30 days to send the documents.
• You must send the documents before you can start using your coverage.
• Your coverage start date is based on when you pick a plan.
• You can’t use your coverage until your eligibility is confirmed and you make your first premium payment.
• If your eligibility notice doesn’t say you need to submit documents, you don’t have to. Simply pick a plan and enroll.