Getting health coverage outside Open Enrollment

Getting 2015 coverage with a Special Enrollment Period

After February 15, 2015, you can enroll in a 2015 health insurance plan only if you have a life event that qualifies you for a Special Enrollment Period.

SEE IF YOU QUALIFY FOR A SPECIAL ENROLLMENT PERIOD

Answer a few questions to find out if you qualify for a Special Enrollment Period. If you already know you do, select the button below and we’ll take you to apply or update your application.

Life events that may qualify you for a Special Enrollment Period

  • Getting married
  • Having a baby
  • Adopting a child or placing a child for adoption or foster care
    Losing other health coverage

    Examples of losing coverage that qualify you for a Special Enrollment Period:

    • Losing job-based coverage for any reason:

      • Your employer stops offering coverage
      • You leave your job by choice
      • You get laid off or fired
      • You choose not to re-enroll in a job-based plan when its plan year ends (But see note below.) (Quitting a plan before the year ends doesn’t qualify.)
    • Your job-based plan not meeting the definition of affordable or minimum value, and as a result you become newly eligible for a premium tax credit

    • Losing coverage through a divorce
    • COBRA coverage ending (Note: If you cancel COBRA before it ends you don’t qualify for a Special Enrollment Period.)
    • Turning 26 and losing coverage under a parent’s plan
    • Losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)(including your child aging off CHIP)

    Be careful about dropping coverage

    • If you voluntarily drop coverage before the plan year ends: You don’t qualify for a Special Enrollment Period. You also don’t qualify if you lose coverage because you don’t pay your premium.
    • If you don’t renew a job-based plan when its plan year ends: You do qualify for a Special Enrollment Period to buy a Marketplace plan. Very important: If the job-based plan you don’t renew is considered affordable and meets minimum value, you won’t qualify for a premium tax credit that lowers the cost of your plan. Ask your employer to complete the Employer Coverage tool (PDF) to see if your job-based plan meets these requirements.
  • Moving to a new residence
  • Gaining citizenship or lawful presence in the U.S.
  • Leaving incarceration
  • For people already enrolled in Marketplace coverage:
    • Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions
    • Note: Voluntarily quitting a Marketplace plan mid-year doesn’t qualify you for a Special Enrollment Period.

FYI Members of federally recognized Indian Tribes or Alaska native shareholders can enroll in or change plans once per month any time of year (not just during Open Enrollment).

If you qualify for a Special Enrollment Period

You can apply online or by phone. Before you apply, you can use a checklist to gather everything you need before you call or log in (PDF).

To enroll with a Special Enrollment Period online

You’ll enroll in different ways depending on whether you already have Marketplace insurance.

If you don’t have Marketplace coverage

Visit our screener, enter your ZIP code, then select the bottom button reading “Start an application.”

If you already have Marketplace coverage

You must report the life change that qualifies you for a Special Enrollment Period on your Marketplace application and then enroll in your new plan:

Need to upload documents to report your change? Learn how to upload documents.

To enroll with a Special Enrollment Period by phone

You can contact the Marketplace Call Center to enroll by phone. Be sure to tell the representative you think you qualify for a Special Enrollment Period. They will verify whether you do.

More answers: Special Enrollment Periods

What if I’m turned down for a Special Enrollment Period but I think I qualify?

You can appeal the decision. Learn how to appeal the decision to deny you 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.

If I missed the Open Enrollment deadline and don’t qualify for a Special Enrollment Period, when can I buy a Marketplace health plan?

The Open Enrollment period for 2016 coverage is November 1, 2015 to January 31, 2016.

In the meantime, you can sign up for Marketplace emails to get timely reminders to help you enroll next year.