Most people associate health insurance enrollment with strict deadlines—but what happens if you need coverage outside of the annual open enrollment window? That’s where Special Enrollment Periods (SEPs) come in. SEPs are time-limited opportunities that let you sign up for a health plan if you’ve experienced certain life changes, like losing a job or getting married. Knowing how SEPs work can help you avoid going without coverage when you need it most. Here’s everything you need to know about qualifying events, timelines, and how to take advantage of your special window to enroll.
What Is a Special Enrollment Period (SEP)?
A Special Enrollment Period is a designated time when you can enroll in a Marketplace health insurance plan, even though it’s not the standard open enrollment period (typically held from November 1 to January 15 in most states).
SEPs are triggered by qualifying life events—major changes in your life that impact your health coverage needs or eligibility. Once a SEP is triggered, you usually have 60 days to enroll in a new plan or make changes to your existing one.
Common Qualifying Life Events
There are several events that can trigger a SEP, including:
Losing health insurance
Job loss
Loss of Medicaid or CHIP
Aging out of a parent’s plan at 26
Divorce or separation affecting your coverage
Losing coverage due to death of a spouse or parent
Changes in household
Marriage
Divorce
Having a baby or adopting a child
Death in the family that affects your coverage
Changes in residence
Moving to a new ZIP code or county
Moving to the U.S. from another country
Moving to or from a shelter or transitional housing
Seasonal workers moving between job locations
Other qualifying events
Becoming a U.S. citizen
Leaving incarceration
Gaining or losing eligibility for premium tax credits or cost-sharing reductions
Changes in income that affect your Marketplace plan or Medicaid eligibility
Special Enrollment for Medicaid and CHIP
If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can enroll any time of year—no SEP or open enrollment period required. However, if you lose Medicaid or CHIP, that’s considered a qualifying event for Marketplace insurance, and you’ll be granted a SEP.
How Long Does a Special Enrollment Period Last?
Most SEPs give you 60 days from the date of the qualifying event to enroll in a new health plan or update your current plan. If you miss this window, you may have to wait until the next open enrollment period to get coverage unless you qualify for another SEP.
What You’ll Need to Apply During a SEP
Applying for coverage during a SEP is similar to enrolling during open enrollment, but you may need to provide documentation to prove your qualifying event.
You may be asked for:
Termination letter from your previous health insurance
Marriage or birth certificate
Court documents for divorce or adoption
Lease agreement or utility bill to confirm a new address
Proof of release from incarceration or immigration documents
The HealthCare.gov website and most state-based Marketplaces will guide you through the specific documentation needed for your situation.
Special Enrollment Periods for Medicare
If you’re on Medicare, there are separate SEPs available. Some reasons you might qualify for a Medicare SEP include:
Losing other creditable coverage
Moving out of your plan’s service area
Gaining eligibility for a Medicare Advantage plan due to Medicaid status or living in an institution
Getting released from prison
Changes in residence or plan availability
The timeframes and rules differ from Marketplace SEPs, so be sure to check with Medicare.gov or a licensed advisor if you’re unsure.
What Happens If You Miss Your SEP Window?
If you miss the 60-day SEP window, you generally cannot enroll in or change Marketplace health insurance until the next open enrollment period.
However, there may be exceptions:
State-specific SEPs: Some states have more flexible rules.
Extraordinary circumstances: Natural disasters or technical errors may extend your enrollment window.
Extended Medicaid eligibility: If you’re still eligible for Medicaid, you can reapply at any time.
How to Enroll During a SEP
Visit HealthCare.gov or your state’s health insurance marketplace
Create or log into your account
Report your qualifying life event
Submit any requested documentation
Compare available plans and enroll within the 60-day window
Tip: The earlier you act, the sooner your coverage can begin—often the first of the month following your application.
Extra Help: Navigators and Enrollment Assistance
If you’re not sure how to start or whether you qualify, free help is available. Marketplace navigators, enrollment counselors, and licensed agents can guide you through the process and help with paperwork or questions.
Find assistance through:
Local community health centers
Nonprofit health advocacy groups
Your state’s health insurance website
Final Thoughts
Life happens—and your health insurance should be able to adapt when it does. Special Enrollment Periods offer a crucial opportunity to stay covered during transitions, whether you’re dealing with a job change, a growing family, or a move. By understanding how SEPs work and acting quickly, you can make sure you have the coverage you need when it matters most. Don’t let the window close—know your options and take advantage of them.
