Health Insurance Marketplace Navigator
Special Enrollment Periods
Every year there are special enrollment periods for people who have certain qualifying life changes or circumstances. The periods are generally for 60 days from the time of the change. Here are some of the reasons you might qualify for special enrollment.
- Having a baby
- Adopting a child or placing a child for adoption or foster care
- Losing other health coverage
- Permanently moving outside your plan’s coverage area (even moving within your state)
- Gaining citizenship or lawful presence in the U.S.
- Gaining or continuing status as a member of an Indian tribe or an Alaska Native shareholder. Members of federally recognized Indian tribes and Alaska native shareholders can sign up for or change plans once per month throughout the year.
- 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 Answer a few questions to find out if you qualify for a Special Enrollment Period.
There are some other complicated cases that may qualify you for a SEP. Some are listed here. Go to www.healthcare.gov/sep-list for a more complete list and call a navigator 1-855-274-5626 if you need assistance.
You faced a serious medical condition or natural disaster that kept you from enrolling. For example:
- An unexpected hospitalization or temporary cognitive disability
- A natural disaster, such as an earthquake, massive flooding, or hurricane
If you applied for Medicaid through your state, or were sent to Medicaid from the Marketplace, but you weren’t eligible for Medicaid.
Your state transferred your information to the Marketplace but you didn’t get an answer about your eligibility and/or didn’t get enrolled before February 15.
System errors related to immigration status
An error in the processing of applications or system caused you to get an incorrect immigration eligibility result when you tried to apply for coverage.
Display errors on HealthCare.gov
Incorrect plan data was displayed at the time that you selected your health plan, such as benefit or cost-sharing information.
Victims of domestic abuse
You’re a victim of domestic abuse and weren’t previously allowed to enroll and receive advance payments of the premium tax credit separately from your spouse. You will be able to do so now.
Other system errors
Other system errors that kept you from enrolling, as determined by the Centers for Medicare and Medicaid Services.