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Special Enrollment Periods: Getting Coverage Outside Open Enrollment

The life events that let you buy health insurance outside open enrollment, and how long you have to act.

Outside of open enrollment, you can only buy an individual or family plan if you have a qualifying life event. Most events give you 60 days to pick a plan.

Common qualifying events

  • Losing health coverage, such as leaving a job with insurance, aging off a parent's plan at 26, or losing Medicaid.
  • Moving to a new ZIP code or county with different plans (you usually need to have had coverage before the move).
  • Household changes: marriage, divorce in some cases, having or adopting a baby, or a death in the family.
  • Income changes that newly make you eligible for subsidies in some situations.
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Licensed agents compare plans from several carriers, check your doctors and estimate your subsidy. Free to you.

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What doesn't count

Simply deciding you want insurance, or getting sick, isn't a qualifying event. Voluntarily dropping coverage or not paying premiums usually isn't either.

Proof

You may be asked for documents, such as a letter showing the date your old coverage ended. Gather them early so your enrollment isn't held up.

Not sure if you qualify?

A licensed agent can tell you whether your situation qualifies and how long you have.

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