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.