Special Enrollment Periods (SEPs) allow you to enroll in a private health plan through the Marketplace outside of the regular Open Enrollment period. Here are some scenarios that may qualify you for a Special Enrollment Period:
- Qualifying life events:
- Getting married
- Having a baby
- Losing health coverage
- Unexpected Situations:
- Unexpected hospitalization or temporary cognitive disability
- Natural disasters like earthquakes, floods, or hurricanes
Note: To qualify due to a natural disaster, you must live (or have lived during the event) in a county eligible for “individual assistance” or “public assistance” by the Federal Management Agency (FEMA). You will have 60 days from the end of the FEMA-designated incident period to complete your enrollment in Marketplace coverage.
- Enrollment or Plan Information Errors:
- Misinformation, misrepresentation, misconduct, or inaction by someone helping you with enrollment prevented you from:
- Enrolling in the right plan
- Receiving the premium tax credit or cost-sharing reduction you qualified for
- Technical errors during your application on HealthCare.gov may also qualify you for an SEP.
- Become Newly Eligible for Savings:
- If you previously lived in a state that has not expanded Medicaid and were nor eligible for Medicaid or premium tax credits due to low income, but if your household income increased or you moved, you may be newly eligible for premium tax credits.
- Gaining or becoming a dependent due to court order:
- If you gained a new dependent or become a dependent of someone else due to child support or court order, you may qualify for a SEP.
For a more detailed list and explanation for all Special Enrollment Periods, click here.