Special enrollment opportunities

The yearly period (November 1 – January 15) when people can enroll in a Marketplace health insurance plan.

Refer to glossary for more details.

, you can only enroll in or change Marketplace plans if you qualify for a Special Enrollment Period

A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

Refer to glossary for more details.

based on certain life changes or your estimated household income. Check if you qualify.

Life changes

Special Enrollment Period details vary based on the life change:

Changes in household

You may qualify for a Special Enrollment Period if in the past 60 days you or anyone in your household:

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. Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
Died. You’ll qualify for a Special Enrollment Period if someone on your Marketplace plan dies which causes you to lose your current health plan.

Changes in residence

You may qualify for a Special Enrollment Period if you move to:

New home in a new ZIP code or county
The U.S. from a foreign country or United States territory

Or, move to or from:

Place you attend school (if you're a student)
Place you both live and work (if you're a seasonal worker)
Shelter or other transitional housing

Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.

You must prove you had qualifying health coverage

Any health insurance that meets the Affordable Care Act requirement for coverage. The fee for not having health insurance no longer applies. This means you no longer pay a tax penalty for not having health coverage.

Refer to glossary for more details.

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 coverage

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.

Select the type of coverage you lost for Special Enrollment Period details:

Job-based coverage

You may qualify for a Special Enrollment Period if you lose health coverage through your employer or the employer of a family member, including if you lose health coverage through a parent or guardian because you're no longer a dependent.

Voluntarily dropping coverage you have as a dependent doesn't qualify you for a Special Enrollment Period unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan.

Individual health coverage

You may qualify for a Special Enrollment Period if you lose individual health coverage, including if:

Your individual plan or your Marketplace plan is discontinued (no longer exists).
You lose eligibility for a student health plan.
You lose eligibility for a plan because you no longer live in the plan’s service area.
Your individual or group health plan coverage year is ending in the middle of the calendar year and you choose not to renew it.
Your household income decreased, and now you qualify for savings on a Marketplace plan.

You won’t qualify for a Special Enrollment Period if you lost coverage because you didn’t provide required documentation. Get details about sending documents.

Medicaid or the Children’s Health Insurance Program (CHIP) coverage (or were denied Medicaid/CHIP)

You may qualify for a Special Enrollment Period if you lost Medicaid or CHIP since March 31, 2023. You may also qualify if you lose or were denied Medicaid or CHIP coverage because:

You're no longer eligible, like if you had a change in household income that makes you ineligible for Medicaid.
Your child ages off CHIP.
You applied for Medicaid /CHIP or Marketplace coverage during Open Enrollment or with a different Special Enrollment Period and were told you might be eligible for Medicaid/CHIP. But, when your state agency told you that you weren’t eligible, Open Enrollment or your Special Enrollment Period had already ended.

Eligibility for Medicare

You may qualify for a Special Enrollment Period if you lose premium-free

A federal health insurance program for people 65 and older and certain younger people with disabilities. It also covers people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD).

Refer to glossary for more details.

You don’t qualify for a Special Enrollment Period if you lose:

Medicare Part A because you didn’t pay your Medicare premium.
Medicare Parts B or D only.

Coverage through a family member

You may qualify for a Special Enrollment Period if you lose qualifying health coverage you had through a parent, spouse, or other family member. This might happen if you lose health coverage because:

You turn 26 (or the maximum dependent age allowed in your state) and can no longer be on a parent’s plan. Get details when you turn 26.
A family member loses health coverage or coverage for their dependents.
A divorce or legal separation.
The death of a family member.
You’re no longer a dependent.

You won’t qualify for a Special Enrollment Period if you chose to drop the coverage you have as a dependent, unless you also had a decrease in household income or a change in your previous coverage that makes you qualify for savings on a Marketplace plan.

An employer offer to help with the cost of coverage

You may qualify for a Special Enrollment Period if you (or anyone in your household) were offered an individual coverage HRA

Health Reimbursement Arrangements (HRAs) are employer-funded group health plans from which employees are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year. Unused amounts may be rolled over to be used in subsequent years. The employer funds and owns the arrangement. Health Reimbursement Arrangements are sometimes called Health Reimbursement Accounts.

Refer to glossary for more details.

Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Small employers who don't offer group health coverage to their employees can help employees pay for medical expenses through a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA). If your employer offers you a QSEHRA, you can use it to help pay your household's health care costs (like your monthly premium) for qualifying health coverage.

Refer to glossary for more details.

in the past 60 days OR expects to in the next 60 days.

Your employer may refer to an individual coverage HRA by a different name, like “ICHRA." Get details about offers for individual coverage HRAs and Qualified Small Employer HRAs.

If you qualify to enroll in Marketplace coverage through this Special Enrollment Period, contact the Marketplace Call Center to complete your enrollment. You can’t do this online.

More qualifying changes

Other situations that may qualify you for a Special Enrollment Period:

Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Becoming a U.S. citizen
Leaving incarceration
Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member

You may have to submit documents

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 have to submit documents that confirm your life event.