Enrollment Periods

Open Enrollment Period

Open Enrollment Period is the yearly period when people can enroll in a health insurance plan.  2021 Open Enrollment Period runs from November 1 - December 15, 2020.  You do not need a qualifying life event to enroll in a health insurance plan during the Open Enrollment Period.

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Special Enrollment Period

Special Enrollment Period is a time outside of the annual Open Enrollment Period when an individual can enroll in a health insurance plan.

An individual must experience a qualifying life event and provide proof of eligibility in order to qualify. During the Special Enrollment Period, individuals may enroll in a plan on or off the Health Insurance Marketplace or change from one Qualified Health Plan to another. The Special Enrollment Period lasts 60 days from the date of a triggering event for qualified individuals or their dependents to enroll in a health plan and to obtain coverage any time of the year.

Open Enrollment for 2020 is over, but you may still be able to enroll in a health insurance plan for 2020 if you qualify for a Special Enrollment Period, either through the Marketplace or directly from a health insurance carrier. Certain life events like getting married, having a baby, or losing other health coverage enable you to enroll outside the Open Enrollment Period.

  • Job-based plans may have different Open Enrollment Periods. Check with your employer.
  • You can apply and enroll in Medicaid or the Children's Health Insurance Program (CHIP) any time of year.

What Are Examples of Qualifying Life Events?

Qualifying life events are significant changes in your life that enable you to enroll in a health insurance plan outside of the Open Enrollment Period. These qualifying life events may cause you to lose your health coverage or have a change in family status or residency.

Losing Your Health Coverage

  • losing coverage because your current health insurance carrier left the service area
  • losing job-based coverage for any reason, including resigning, getting laid off, or getting fired
  • expiring COBRA coverage
  • losing coverage under your parents’ plan at age 26
  • getting divorced or legally separated (resulting in loss of coverage)
  • losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)

Note: Losing coverage that doesn’t qualify as minimum essential coverage doesn’t qualify you for a Special Enrollment Period. Learn more at HealthCare.gov

Change In Your Household Size

  • getting married
  • having a baby
  • adopting a child or placing a child for adoption or foster care
  • death of family member (causing you to lose eligibility in your current plan)

Change In Circumstance

Change In Status

  • getting released from jail or prison
  • gaining citizenship or lawful presence in the U.S.

For more information on required documentation, please visit HealthCare.gov

How Soon Can Coverage Start During A Special Enrollment Period?

Most qualifying life events allow you to enroll and begin coverage the first day of the next month if you enroll by the 15th of the month. If you enroll after the 15th of the month, your coverage will begin the first day of the following month. For example, if you enroll on May 10, your coverage starts June 1. If you on enroll May 17, your coverage starts July 1. This works the same as it does during the Open Enrollment Period. However, there are a few exceptions which allow same-day effective coverage to begin:

  • birth of child
  • adoption of child

How Long Does A Special Enrollment Period Last?

A Special Enrollment Period is triggered by a qualifying life event and typically lasts for 60 days. However, the Special Enrollment Period may vary based on the type of qualifying life event.

What Is A Hardship Exemption?

A hardship exemption is an exceptional circumstance, and it triggers a 60-day Special Enrollment Period. Examples of exceptional circumstances are unexpected hospitalizations, natural disasters, or temporary cognitive disability. Other hardships may include enrollment errors created by HealthCare.gov, your broker or by your insurance carrier. For more information, please visit HealthCare.gov.

Qualifying Life Event Special Enrollment Period (SEP)
Getting Married Up to 60 days after the event.
Having a baby, adopting or placing a child for adoption Up to 60 days after the event.
Losing your health coverage Up to 60 days before and up to 60 days after the event.
Moving outside your plan's coverage Up to 60 days after the event.
Note: Only triggers SEP if it's not during open enrollment.
Gaining U.S. citizenship Up to 60 days after the event.
Note: Only triggers SEP if it's not during open enrollment.
Change in income or household status that affects eligibility
for premium tax credits or cost-sharing reductions
Up to 60 days after the event.
Note: Only triggers SEP if it's not during open enrollment.
Being denied Medicaid or CHIP Up to 60 days after the event.
Release from prison or jail Up to 60 days after the event.
Note: Only triggers SEP if it's not during open enrollment.
Hardship Exemption Up to 60 days after the event.

Open Enrollment Ends December 15, 2020


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