What Qualifying Events Allow Me to Get Coverage Outside Open Enrollment?

There are a handful of special circumstances and life events that could qualify you for a special enrollment period. This begins 60 days before the trigger event and lasts 60 days after the trigger event date. The most common “qualifying events” include:

1. You or a dependent lose job-based coverage
2. You get married, have a baby, or adopt
3. You gain US citizenship
4. Your income changes significantly, making you newly eligible (or ineligible) for subsidies
5. You permanently move out of state and gain access to new plans
6. You are or gain status as a Native American Indian
7. Turning 26 and aging off your parent’s plan

If you have a baby, adopt a child, or place 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.

For other qualifying events plans, if you apply between the 1st and 15th of the month, you plan will start on the 1st day of the next month. If you apply after the 15th of the month, your plan will start on the 1st day of the month following month.

Example: Jim moves from California to Illinois on May 3rd. He applies for an Illinois health plan on May 5th. His plan start date will be June 1st. 

Example 2: Mary loses her employer coverage on May 1st. She waits and applies for an individual plan on May 25th. Even though her employer coverage ended May 1st, her individual plan start date will be July 1st because she applied after the 15th of the month.