Missed Open Enrollment? Learn About A Special Enrollment Period.

Special Enrollment Period


What are Special Enrollment Periods?

Open Enrollment is the time each year where anyone can shop on the marketplace for health insurance coverage.  This ended for 2018 insurance plans on December 15, 2017. If you missed open enrollment you may still be able to enroll on the Marketplace if you experience certain qualifying life events. When you experience one of these events it triggers a Special Enrollment Period which allows you to use the Marketplace to get or change your coverage between regular Open Enrollment Periods.

What is a Qualifying Life Event?

If in the past 60 days any of the events below happened to you or someone in your household you may qualify for a Special Enrollment Period.

  • Loss of qualifying health coverage
    • Lose employer based coverage (including losing coverage from a spouse)
    • Lose coverage from your parents when you turn 26
  • Change in household size
    • Getting married
    • Having a baby
    • Adopting a child or having a child placed with you for foster care
    • Getting divorced and losing health coverage
    • Death resulting in loss of coverage
  • Changes in residence or income
    • Changing your primary place of living
      • Into a new zip code
      • From abroad
      • To and from school
      • To and from seasonal work
    • Change in income
  • Change in status
    • Gaining citizenship or lawful presence in the US
    • Being released from incarceration

You also qualify for a Special Enrollment Period if you are a member of a federally recognized tribe or an Alaska Native corporation shareholder. Learn more about all the health coverage options for American Indians living in Montana here.

You may think you qualify, but taking the SEP evaluator here will help you figure it out!

You Qualify for a Special Enrollment Period, Now What?

After you figure out that you qualify for a special enrollment period then you should apply for coverage. You can apply online at healthcare.gov or on the phone. For most SEPs, you have 60 days from the life event to apply. Also, there are certain SEPS that you can apply for coverage prior to the event. In addition, certain SEPs require you to verify that you qualify for them through certain documentation, which is due within 30 days after the first notification, so, it’s important to keep in mind timing.

Dates and details matter with SEPs – an enrollment assister can help! Therefore as processes change, the best way to get coverage or to have your questions answered is to find your local assister here.