Marketplace 101: What is a Special Enrollment Period

Marketplace 101: What Is a Special Enrollment Period?

How you may be able to get health insurance after open enrollment has ended

September 16, 2024 | 6 min read

Are you in need of health insurance coverage for you and your family? During open enrollment, which is Nov. 1 through Jan. 15, it’s easy to sign up for a plan on the Health Insurance Marketplace. But how do you get health insurance when it’s no longer open enrollment and you find yourself in need?

There are some ways to get coverage outside of open enrollment. If you lost job-based health insurance, moved, had a baby, or experienced other life changes, you may qualify for a special enrollment period. A special enrollment period (SEP) is a time outside the yearly open enrollment period when you can sign up for health insurance, if you qualify.

How to Qualify for a Special Enrollment Period

To qualify for an SEP, you must have experienced a “qualifying life event.” There are several types of life changes that can enable you to enroll in Marketplace insurance outside of open enrollment. Some of the most common include:

  • Change in marital status
  • Birth or adoption of a child
  • Relocation to a new ZIP code or county
  • Release from incarceration
  • Death of a family member who provided coverage for you
  • Loss of job-based coverage
  • Aging out of parents’ coverage at age 26

Not sure if you qualify? Learn more about qualifying life events or get help from our licensed agents by calling 844-933-0380 (TTY: 711) from 8 a.m. to 9 p.m. ET.

Sign-Up Time is Limited

After a qualifying life event, you’ll most likely have 60 days to enroll in a Marketplace insurance plan. If you know that you will have a life event in advance, such as the birth of a child or a planned relocation, you may be able to start the sign-up process as early as 60 days in advance. It’s best to start as soon as you can to try to avoid lapses in health insurance coverage.

Pro Tips

If you are eligible for Medicaid or the Children’s Health Insurance Program (CHIP), you can get coverage at any time.

Savings are Available

Just like during open enrollment, there are ways to save during SEPs. Depending on your situation, you may be able to qualify for premium tax credits and cost-sharing reductions.

See if you qualify for a special enrollment period. If you do, our easy-to-use enrollment system will walk you through the process and help identify savings opportunities.

You can also contact our knowledgeable Ambetter Health team at 844-933-0380 (TTY: 711) from 8 a.m. to 9 p.m. ET to learn more about your health insurance options. Our licensed agents can help you find the right plan for your unique needs.

Questions About Special Enrollment Periods

You may be able to get health insurance after open enrollment if you qualify for a special enrollment period due to a qualifying life event. If you don’t qualify for a special enrollment period, you may be able to get temporary health coverage from a private insurance company.

A special enrollment period is not linked to any specific time of the year. It starts 60 days before your qualifying event and lasts for 60 days after the event happens. If you are eligible, you can get Medicaid and CHIP coverage at any time.

Pregnancy does not qualify you for an SEP, but childbirth does. If you don’t currently have medical insurance and don’t qualify for a special enrollment period during your pregnancy for another reason, you’ll be eligible to apply within 60 days of giving birth.

You don't qualify for an SEP if you lost coverage on a Marketplace plan due to non-payment. You'll have to wait for the next open enrollment period to enroll in Marketplace coverage unless you qualify for a special enrollment period for another reason.

See if you qualify for a special enrollment period. If you do, our easy-to-use enrollment system will walk you through the process and help identify savings opportunities.

You can also contact our knowledgeable Ambetter Health team at 844-933-0380 (TTY: 711) from 8 a.m. to 9 p.m. ET to learn more about your health insurance options. Our licensed agents can help you find the right plan for your unique needs.

Shop Ambetter Health Plans

Find a health insurance plan with the right out-of-pocket max to meet your needs.

Or call our helpful team:

844-933-0380 (TTY: 711)

8 a.m. to 9 p.m. ET

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