Special Enrollment Period
Plain English
A Special Enrollment Period lets you sign up for health insurance outside Open Enrollment after certain life events, like losing job-based coverage, moving, marriage or a new baby. You usually have 60 days from the event. Choosing to drop coverage on your own generally doesn't qualify. Employer plans offer special enrollment after certain events too.
Read to the end to complete this term.
On this page
Definition
A Special Enrollment Period is a time outside the yearly Open Enrollment Period when a person can enroll in or change health insurance because of a qualifying life event, such as losing other coverage, moving, getting married, or having or adopting a child. For most events on the Marketplace, the window is 60 days.
Why It Matters
Life events don't wait for November. A Special Enrollment Period is how most people avoid a gap after losing a job, aging off a parent's plan or moving to a new state, but only if they act within the window.
Real-World Example
Imagine a couple marries on April 10. One spouse adds the other to a Marketplace plan by April 30, the last day of the month, so coverage starts May 1. If they had waited until July, more than 60 days later, they'd likely have to wait for Open Enrollment.
Common Misconceptions
- Any change in your life qualifies. Only certain events do, such as losing coverage, moving, marriage or a birth.
- You can wait as long as you want after the event. The window is usually 60 days.
- Dropping COBRA voluntarily qualifies. HealthCare.gov says it doesn't.
Key Takeaways
- HealthCare.gov lists household changes, residence changes and loss of qualifying coverage among qualifying events.
- Loss of coverage counts if it happened in the past 60 days or is expected in the next 60.
- After marriage, a plan picked by the end of the month can start the first day of the next month.
- After a birth or adoption, coverage can start the day of the event.
Frequently Asked Questions
What is a Special Enrollment Period?
A window outside Open Enrollment to enroll in or change health insurance after a qualifying life event.
What life events qualify for a Special Enrollment Period?
Examples include losing qualifying coverage, moving, getting married, and having, adopting or fostering a child.
How long is a Special Enrollment Period?
Usually 60 days from the event on the Marketplace. Losing Medicaid or CHIP can allow 90 days.
Does losing my job qualify me?
Losing job-based coverage generally does, within 60 days. You can enroll in a Marketplace plan or consider COBRA.
Related Terms
Related Coverages
- Health Insurance
Related Scenarios
Explore the rest of the Health Insurance category.
Browse Health Insurance terms →Sources
The factual claims on this page were checked against these sources. Rules and figures change, so check the source itself if you need to confirm the current version.
- healthcare.govGetting health coverage outside Open Enrollment · HealthCare.gov (U.S. Centers for Medicare & Medicaid Services)
Educational information, not advice: This page is for general education only, not legal, financial, or insurance advice. Actual coverage, discounts, and requirements depend on your policy’s wording, your insurer, and the laws of your state. Confirm specifics with your own insurer or a licensed agent before making a decision. Insurpedia does not sell insurance and does not recommend specific insurers.