Special Enrollment for Health Insurance

What Is A Special Enrollment Period?


Special Enrollment Periods occur outside the Open Enrollment time frame. If you miss the opportunity to sign up for Marketplace health insurance during Open Enrollment (typically November 1 to January 15, although the dates can vary by state), you still may have a chance to sign up during a Special Enrollment Period if you have a qualifying life-changing event.

What Life Changes Qualify You For A Special Enrollment Period?


Some of the most common qualifying life events for a Special Enrollment Period include:

  • Having a baby or adopting a child.
  • Losing your existing health coverage.
  • Moving to a new ZIP code or county.
  • Becoming divorced or separated.
  • Experiencing the death of a spouse or partner who provided health insurance coverage.


What Other Qualifying Life-changing Events Make You Eligible For Special Enrollment?


Any circumstances that cause you to lose or experience a change in health insurance coverage may be eligible as a qualifying event. 



When Can You Sign Up For A Special Enrollment Period?


You generally have 60 days before or 60 days following the qualifying life event to enroll in a plan. In most cases, coverage must be selected by the 15th of the month to be effective the first of the following month. There are some exceptions (birth or adoption of a child, marriage, and involuntary loss of coverage) that have different rules for coverage effective dates. When you apply, you may be required to submit documents that confirm your eligibility to enroll based on the life event you experienced.



How Soon Does My Special Enrollment Coverage Start?


If you qualify for Special Enrollment and sign up for a health plan, your coverage typically starts once you’ve paid your first monthly premium. In some instances, retroactive coverage may be offered based on a past date that aligns to your qualifying life event, such as the birth of a child.

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