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Special enrollment periods

When to enroll in a health plan

You can buy health insurance plans during open enrollment or when you experience a qualifying life event.

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Open enrollment period

The annual open enrollment period for the Health Insurance Marketplace is November 1 through January 15.

  • For coverage to start on January 1 of the following year, you must enroll in or change plans by December 15 and pay your first premium.
  • If you enroll and pay your first premium between December 15 and January 15, your coverage will start on February 1 of the following year.

During the open enrollment period, you can enroll in a health insurance plan as well as a dental plan and vision plan.

Special enrollment period (SEP)

You may qualify to enroll in a new plan during a special enrollment periods (SEP), if you miss open enrollment or experience a qualifying life event. SEPs can help you:

  • Avoid gaps in your coverage.
  • Stay on top of your health care needs.
  • Take action quickly and adapt to life's changes.

Find out more about SEPs, including information about qualifying life events, finding coverage, and more.

Have questions about SEPs? Call us at 800-383-1514.

What is a special enrollment period (SEP)?

An SEP lets you enroll in health coverage or switch plans outside of an open enrollment period. As set by the US Department of Health & Human Services, you might be eligible for an SEP if you go through certain qualifying life events, including:

  • Moving your residence
  • Getting married
  • Having a baby or adopting a child
  • Losing your current coverage, and more

The timeframe for enrolling in or changing a plan during an SEP varies – it could be 60 days before or after the event depending on the type of SEP.

Insurance special enrollment periods

Healthcare.gov offers special enrollment periods for many situations, including:

Changes in household

If you or anyone in your household:

  • Gets married
  • Has a baby, adopts, or places a child in foster care
  • Loses health insurance due to a divorce or legal separation
  • Passes away

Changes in residence

If you move to:

  • A different ZIP Code or county within the US
  • The US from outside the country

Or, move to or from:

  • A place you attend school
  • A place you both live and work (if you're a seasonal worker)
  • A shelter or other transitional housing

Loss of health insurance

If you or anyone in your household loses health coverage from:

  • An employer
  • An individual health insurance plan
  • Medicaid or Children’s Health Insurance Program (CHIP)
  • Medicare
  • A family member's plan (for example, dependents turning 26 years old)

Other situations

If you or anyone in your household:

  • Are offered a Health Reimbursement Arrangement (HRA) or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) through your employer
  • Gains membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becomes a US citizen
  • Leaves incarceration
  • Starts or ends service as an AmeriCorps State and National, Volunteers in Service to America (VISTA), or National Civilian Community Corps (NCC) member

How to apply for a special enrollment period

If you believe you qualify for an SEP, you can apply through Healthcare.gov by creating a Marketplace account or contacting the Marketplace Call Center.

When you apply, you must confirm that the information you provide is true, and you may be required to submit documentation that proves your eligibility.

If the Health Insurance Marketplace says you're not eligible for an SEP, you can appeal the decision within 90 days of the eligibility notice. Learn how to appeal and which form to submit on the Health Insurance Marketplace.

Point of Blue

Visit our blog for more tips to get the most out of open enrollment or special enrollment periods.

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