Annual 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 instead go into effect on February 1.
When else can I buy health insurance?
If you miss open enrollment or experience a qualifying life event for insurance, you may also be able to enroll in or change your plan during special enrollment periods (SEPs).
Understanding SEPs is vital as they offer unique opportunities to ensure your health insurance coverage adapts to various changes in your life.
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 annual open enrollment period, or during open enrollment for an earlier coverage start date.
As set by the US Department of Health & Human Services, you might be eligible for an SEP if you undergo any of several 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
The Health Insurance Marketplace offers special enrollment periods for the following life situations. For the complete list and important dates for selecting coverage and when coverage starts, visit Healthcare.gov.
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, 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 an account or contacting the Marketplace Call Center.
When you apply, you must attest that the information you provide is true, and you may be required to submit documentation that confirms 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. Visit healthcare.gov to learn how to appeal and which form to submit.
Point of Blue Blog
Visit our blog for more tips to get the most out of open enrollment or special enrollment periods.
Disclosures:
Special Enrollment Periods are available for individuals with qualifying life events. The federal government determines eligibility for health insurance plans purchased on the federally facilitated Marketplace. Details can be found at healthcare.gov.
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