Since the 2017 Open Enrollment Period is over, you can now enroll in or change your Health Insurance Marketplace plan only if you have a life event that qualifies you for a Special Enrollment Period.
See if you qualify for a 2017 Special Enrollment Period
Answer a few questions to find out if you can enroll in or change a plan for 2017.
SEE IF YOU QUALIFY
Life changes that can qualify you for a Special Enrollment Period
Loss of health insurance
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
Coverage losses that may qualify you for a Special Enrollment Period:
- Losing job-based coverage
You may qualify for a Special Enrollment Period if you lose health coverage through your employer or the employer of a family member, including if:
- Your employer stops offering coverage.
- You leave a job where you had health coverage (even if you left your job by choice or were fired).
- You have a reduction in work hours that causes you to lose your job-based plan.
- Your job-based plan doesn’t offer qualifying health coverage and as a result you become newly eligible for a premium tax credit. Most job-based plans count as qualifying health coverage. To find out if your employer’s coverage meets the standards, ask your employer to complete the Employer Coverage Tool (PDF).
- Your job-based health plan is ending for the year and you choose not to renew it. Note: If the plan is affordable and meets minimum value standards, you can buy Marketplace insurance but won’t qualify for a premium tax credit or other savings.
- Your former employer stops contributing to your retirement coverage, requiring you to pay full cost.
Note: You DON’T qualify for a Special Enrollment Period if:
- You voluntarily drop your job-based coverage during your coverage year while still working for your employer.
- You lose your job-based coverage because you didn’t pay your premium.
- Losing COBRA coverage
Some special rules apply if you’re losing COBRA continuation coverage.
You DO qualify for a Special Enrollment Period if:
- Your COBRA coverage runs out.
- Your former employer stops contributing to your COBRA coverage, requiring you to pay the full cost.
You DON’T qualify for a Special Enrollment Period if:
- You decide to end COBRA early (and are paying the full cost yourself).
- You lose your COBRA coverage because you didn’t pay your premiums.
Note: You don’t need a Special Enrollment Period if you voluntarily end COBRA early during a Marketplace Open Enrollment Period. You can drop your COBRA plan and enroll in a Marketplace plan at that time.
- Losing individual health coverage for a plan or policy you bought yourself
You may qualify for a Special Enrollment Period if you lose individual health coverage, including if:
- Your individual plan or your Marketplace plan is discontinued (no longer exists).
- You lose eligibility for a student health plan.
- You lose eligibility for a plan because you no longer live in the plan’s service area.
- Your individual or group health plan coverage year is ending in the middle of the calendar year and you choose not to renew it.
Important: Losing individual coverage doesn’t qualify for a Special Enrollment Period if you voluntarily drop coverage, if you lose coverage because you didn’t pay your premiums, or if you lose Marketplace coverage because you didn’t provide required documentation when the Marketplace asked for more information.
- Losing eligibility for Medicaid or CHIP
You may qualify for a Special Enrollment Period if you lose Medicaid or the Children’s Health Insurance Program (CHIP) because:
- You lose your eligibility. For example, you may have a change in household income that makes you ineligible for Medicaid, or you may become ineligible for pregnancy-related or medically needy Medicaid.
- Your child ages off CHIP.
- Losing eligibility for Medicare
You may qualify for a Special Enrollment Period if you become no longer eligible for premium-free Medicare Part A.
You don’t qualify for a Special Enrollment Period if:
- You lose Medicare Part A because you didn’t pay your Medicare premium.
- You lose Medicare Parts B, C, or D only.
- Losing coverage through a family member
You may qualify for a Special Enrollment Period if you lose qualifying health coverage you had through a parent, spouse, or other family member. This might happen if:
- You turn 26 (or the maximum dependent age allowed in your state) and can no longer be on a parent’s health plan.
- You lose job-based health coverage through a family member’s employer because that family member loses health coverage or coverage for dependents.
- You lose health coverage through a spouse due to a divorce or legal separation.
- You lose health coverage due to the death of a family member.
- You lose health coverage through a parent or guardian because you’re no longer a dependent.
- Important: Losing coverage you have as a dependent doesn’t qualify for a Special Enrollment Period if you voluntarily drop the coverage. You also don’t qualify if you or your family member lose coverage because you don’t pay your premium.
Changes in household size
You may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:
- Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
- Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward, and even if the event happened late in 2016.
- Example: You had a baby December 17, 2016 and enroll in a 2016 plan February 8, 2017. The coverage applies to medical services from December 17 through December 31, 2016. Your 2017 plan would cover your expenses from January 1, 2017 on. Note: If the event happened in 2016, you’ll need to contact the Marketplace Call Center to enroll in 2016 coverage.
- Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
- Death. You’ll be eligible for a Special Enrollment Period if someone on your Marketplace plan dies and as a result you’re no longer eligible for your current health plan.
Changes in residence
Household moves that qualify you for a Special Enrollment Period:
- Moving to a new home in a new ZIP code or county
- Moving to the U.S. from a foreign country or United States territory
- A student moving to or from the place they attend school
- A seasonal worker moving to or from the place they both live and work
- Moving to or from a shelter or other transitional housing
Note: Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for an SEP.
Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.
More qualifying changes
Other life circumstances that may qualify you for a Special Enrollment Period:
- Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
- Leaving incarceration
- AmeriCorps VISTA members starting or ending their service
Learn about Special Enrollment Periods for complex issues.
How to apply for 2017 coverage with a Special Enrollment Period
IMPORTANT: When you apply, you must attest that the information you provide on the application is true, including the facts that qualify you for a Special Enrollment Period. You may be required to provide documents that prove your eligibility to enroll based on the life event you experience.
More answers: Getting 2017 coverage with a Special Enrollment Period
- What if something outside my control prevented me from getting coverage during the Open Enrollment Period?
In a few very limited situations, you could qualify for a Special Enrollment Period. Learn about Special Enrollment Periods for complex issues.