If you miss the Open Enrollment Period date for this year, you can apply for a Special Enrollment Period (SEP), which you can enroll in or change a Marketplace health plan only if you qualify for a Special Enrollment Period.
You may qualify based on estimated household income, or if you experience any of the life events on this page.
If you do not qualify for a Special Enrollment Period, stay tuned to apply for a 2023 health plan from November 1, 2022 to January 15, 2023.
Life changes that may qualify you for a Special Enrollment Period
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Important: If you had a change more than 60 days ago but since January 1, 2020
If you qualified for a Special Enrollment Period but missed the deadline to enroll in coverage because you were affected by the COVID-19 emergency, you may be eligible for a Special Enrollment Period.
If you or someone in your household lost qualifying health coverage in the last 60 days (or more than 60 days ago but since January 1, 2020) OR expects to lose coverage in the next 60 days, you may qualify for this Special Enrollment Period by applying.
You may qualify for a Special Enrollment Period if you or anyone in your household in the last 60 days: have married.
Choose a plan by the last day of the month and your coverage can begin on the first day of the following month.
Had a baby, adopted a child, or placed a child for foster care.
Your coverage can start on the day of the event - even if you enroll in the plan up to 60 days later.
You got divorced or legally separated and lost your health insurance.
Note: Divorce or legal separation without losing coverage does not qualify you for a Special Enrollment Period.
You will be eligible for a Special Enrollment Period if someone in your Marketplace plan dies and as a result is no longer eligible for your current health plan.
Household changes that qualify you for a Special Enrollment Period:
Moving to a new home in a new zip code or county
Moving to the United States from a foreign country or territory of the United States
If you are a student, moving to or from the place where you attend school
If you are a seasonal worker, moving to or from the place where you live and work
Moving to or from a shelter or other transitional housing
Note: Moving only for medical treatment or staying somewhere for a vacation does not qualify you for a Special Enrollment Period.
Important: You must prove that you had qualified health coverage for one or more days during the 60 days prior to your move. You do not need to provide proof if you are moving from a foreign country or territory of the United States.
Loss of Health Insurance
You may qualify for a Special Enrollment Period if you or someone in your household has lost qualified health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
Losses of coverage that may qualify you for a Special Enrollment Period:
Loss of employment-based coverage
Losing individual health coverage for a plan or policy you purchased yourself
Loss of eligibility for Medicaid or CHIP
Loss of eligibility for Medicare
Losing coverage through a family member
An offer by your employer to help with the cost of coverage
You may qualify for a Special Enrollment Period if you or anyone in your household has recently obtained access to individual HRA coverage or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days OR expects to obtain it in the next 60 days.
Note: Your employer may refer to individual HRA coverage under a different name, such as the acronym "ICHRA."
Generally, you will need to apply for and enroll in individual health insurance before your individual HRA or QSEHRA coverage begins. However, your employer may offer different options for when your individual HRA or QSEHRA coverage can begin, so that you have more time to enroll. Contact them or check the notice you receive.
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EPIA inc. is a private Insurance Agency with no ties with legal entities. The information contained in this article is based on information provided by the Medicare Official Website.