Special Enrollment Periods — When You Can Get Health Insurance Outside Open Enrollment

Open Enrollment for ACA Marketplace health insurance runs November 1 through January 15 each year. But what if you missed it — or your situation changed mid-year?

The good news: you may still be able to get covered through a Special Enrollment Period (SEP).

What Is a Special Enrollment Period?

A Special Enrollment Period is a window outside of Open Enrollment during which you're eligible to enroll in or change a health insurance plan due to a qualifying life event. SEPs typically last 60 days from the date of the qualifying event.

Common SEP Qualifying Events

The following events typically trigger a Special Enrollment Period:

• Loss of job-based health coverage (including COBRA expiration)
• Marriage or divorce
• Birth or adoption of a child
• Death of a dependent who was the primary policyholder
• Moving to a new coverage area
• Losing Medicaid or CHIP eligibility
• Gaining citizenship or lawful immigration status
• Release from incarceration
• Becoming a dependent or losing dependent status

What Documentation Do You Need?

Most SEP enrollments require documentation of the qualifying event. For example:

• Job loss: letter from employer or COBRA notice
• Marriage: marriage certificate
• Birth: birth certificate
• Moving: utility bill or lease agreement with new address

What About Medicaid?

Unlike Marketplace plans, Medicaid enrollment is open year-round in Florida. If your income drops and you may qualify for Medicaid, you can apply at any time — no SEP required.

If you're near the Medicaid income threshold, I can help you determine whether a Marketplace plan with subsidies or Medicaid is the right fit for your situation.

Act Quickly — SEP Windows Close Fast

The 60-day SEP window starts from the date of your qualifying event — not when you find out about it. If you've recently had a life change that affects your health coverage, don't wait.