What Is a Special Enrollment Period

A Special Enrollment Period (SEP) is a limited window outside of Open Enrollment when you can enroll in or change your Marketplace health plan due to a qualifying life event. Without a qualifying event, enrollment is restricted to the annual Open Enrollment Period (November 1 – January 15 for federally facilitated marketplace states). SEPs allow you to maintain continuous coverage when life changes happen.

Qualifying Life Events

Loss of health coverage: Losing job-based coverage, COBRA coverage ending, losing eligibility for Medicaid or CHIP, losing student health coverage, or aging off a parent's plan at 26. Voluntarily dropping coverage does not qualify.

Household changes: Getting married or entering a domestic partnership, having a baby, adopting a child, placing a child for foster care, or death of a plan enrollee (for remaining dependents).

Residency changes: Moving to a new ZIP code or county not in your current plan's coverage area, moving back to the U.S. after living abroad, or leaving incarceration.

Other qualifying events: Gaining citizenship or lawful immigration status, errors by the Marketplace or employer during previous enrollment, or being affected by a FEMA-declared natural disaster (which triggers an extended SEP).

60-Day Window — How Timing Works

Most SEPs open a 60-day window from the date of the qualifying event. Missing the 60-day window — even by one day — typically means waiting for the next Open Enrollment. If you're unsure whether your situation qualifies, call the Marketplace at 1-800-318-2596 before the window closes. For loss of coverage, the SEP may begin slightly before your actual coverage end date — allowing you to select a plan with no gap in coverage.

Losing Job-Based Coverage

The most common SEP trigger is losing employer-sponsored health insurance — through job loss, reduction in hours, or employer eliminating coverage. The SEP begins on the date you lose coverage. Key point: COBRA election does not affect your SEP eligibility — you can still use the SEP to enroll in a Marketplace plan even if COBRA is offered. In many cases, a Marketplace plan with subsidies costs significantly less than COBRA. See COBRA vs Marketplace Coverage for the cost comparison.

Losing Medicaid Coverage

Losing Medicaid eligibility — due to income increase, redetermination, or state unwinding — triggers a 60-day SEP for Marketplace enrollment. This was important during the 2023–2024 COVID unwinding when millions were disenrolled from Medicaid. If you receive a Medicaid termination notice, act immediately: apply at healthcare.gov within 60 days to enroll in a Marketplace plan with subsidies if your income falls in the subsidy-eligible range.

Other Qualifying Events

Marriage and having a baby trigger SEPs that allow adding family members to existing coverage or enrolling as a new household. Moving to a new zip code not served by your current plan opens an SEP to select a local plan. All these events require documentation — marriage certificate, birth certificate, COBRA election notice, Medicaid termination letter, etc. Have your documentation ready when you apply.

How to Apply During an SEP

Apply at healthcare.gov during your SEP window. Select the qualifying event that opens your SEP and upload required documentation. The application confirms you're within the 60-day window based on the qualifying event date. Use the Renewal Reminder System to track upcoming qualifying events (like a child turning 26) so you're prepared to act quickly when the window opens.