Marketplace Enrollment Periods

Can I buy or change private health plan coverage outside of Open Enrollment?

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In general, you can have a special enrollment opportunity to sign up for Marketplace coverage during the year, other than during Open Enrollment period, if you have a qualifying life event. Some examples of qualifying life events include marriage, gaining a dependent, or loss of employment. Only one person in a household applying for coverage or financial assistance through the Exchange must qualify for a SEP in order for the entire household to qualify for the SEP. A link provided here gives details on the types of events that would qualify you for a SEP and the timing and coverage effective dates for each event.

Note that some triggering events will only qualify you for a SEP in the health insurance Marketplace; they do not apply in the outside market. If you sign up for a Marketplace plan during a special enrollment period, your coverage will take effect on the first day of the following month, even if you made your selection after the 15th of the month. So, for example, if you will lose coverage starting on February 7 and select your Marketplace plan on January 28, your coverage will begin on February 1. This rule was formerly applicable to only Healthcare.gov enrollees, but starting in 2025 it will be extended to State-based Marketplace enrollees.

States have flexibility to expand special enrollment opportunities for consumers. If you reside in a State-based Marketplace, check with your state Marketplace for more information. If you are unsure if you reside in a State-based Marketplace, or in a state where the Marketplace is offered on the Federal Platform (also known as a Healthcare.gov state or a State-based Marketplace-Federal Platform), click here for more information.

While we have made every effort to provide accurate information in these FAQs, people should contact the health insurance Marketplace or Medicaid agency in their state for guidance on their specific circumstances.

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