Special Enrollment Periods (SEP)
See if you can sign-up for coverage outside of the enrollment period!
SPECIAL ENROLLMENT PERIODS
Normally, there's only one time during the year when you can sign-up for health insurance called "open enrollment". For Marketplace coverage, open enrollment is November 1st-December 15th. Insurance companies do this so people won't sign-up only when they get sick. This keeps costs down for everyone.
However, if you have a life event that causes you to lose health insurance or become eligible for coverage, you can sign-up in the middle of the year. This is called a Special Enrollment Period (SEP).
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.
- Death. 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 United States territory
- A student moving to or from the place they attend school
- A seasonal worker moving to or from the place they 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 an SEP.
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 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 expects to lose coverage in the next 60 days.
- Coverage losses that may qualify you for a Special Enrollment Period:
- Losing job-based coverage
- Losing individual health coverage for a plan or policy you bought yourself
- Losing eligibility for Medicaid or CHIP
- Losing eligibility for Medicare
- Losing coverage through a family member
MORE QUALIFYING CHANGES
Other life circumstances that may qualify you for a Special Enrollment Period:
- Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
- 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
- AmeriCorps State and National, VISTA, and NCCC members starting or ending their service
IMPORTANT: When you apply, you must attest that the information you provide on the application is true, including the facts that qualify you for a Special Enrollment Period. You may be required to provide documents that prove your eligibility to enroll based on the life event you experience.