Enroll in or change 2023 plans — only with a Special Enrollment Period
Life changes that can qualify you for a Special Enrollment Period
Changes in household
You may qualify for a Special Enrollment Period if in the past 60 days you or anyone in your household:
- Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
- Had a baby, adopted a child, or placed 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.
- Got divorced or legally separated and lost health insurance. Note: Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
- Died. You’ll qualify for a Special Enrollment Period if someone on your Marketplace plan dies which causes you to lose your current health plan.
Changes in residence
You may qualify you for a Special Enrollment Period if you move to:
- New home in a new ZIP code or county
- The U.S. from a foreign country or United States territory
Or, move to or from:
- Place you attend school (if you’re a student)
- Place you both live and work (if you’re a seasonal worker)
- Shelter or other transitional housing
Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.
You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don’t need to provide proof if you’re moving from a foreign country or United States territory.
Loss of health insurance
You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days.
You may qualify for a Special Enrollment Period if you lost:
You may qualify for a Special Enrollment Period if you lose health coverage through your employer or the employer of a family member, including if you lose health coverage through a parent or guardian because you’re no longer a dependent.
You may qualify for a Special Enrollment Period if you lose individual health coverage, including if:
- Your individual plan or your Marketplace plan is discontinued (no longer exists).
- You lose eligibility for a student health plan.
- You lose eligibility for a plan because you no longer live in the plan’s service area.
- Your individual or group health plan coverage year is ending in the middle of the calendar year and you choose not to renew it.
- Your household income decreased, and now you qualify for savings on a Marketplace plan.
You may qualify for a Special Enrollment Period if you lost Medicaid or CHIP since March 31, 2023.
You may also qualify if you lose or were denied Medicaid or CHIP coverage because:
- You’re no longer eligible. Like if you had a change in household income that makes you ineligible for Medicaid.
- Your child ages off CHIP.
- You applied for Medicaid/CHIP or Marketplace coverage during Open Enrollment or with a different Special Enrollment period and were told you might be eligible for Medicaid/CHIP. But, when your state agency told you that you weren’t eligible, Open Enrollment or your Special Enrollment Period had already ended.
You may qualify for a Special Enrollment Period if you lose premium-free Medicare Part A.
You don’t qualify for a Special Enrollment Period if you lose:
- Medicare Part A because you didn’t pay your Medicare premium.
- Medicare Parts B or D only.
You may qualify for a Special Enrollment Period if you lose qualifying health coverage you had through a parent, spouse, or other family member. This might happen if you lose health coverage because:
- You turn 26 (or the maximum dependent age allowed in your state) and can no longer be on a parent’s plan.
- A family member loses health coverage or coverage for their dependents.
- A divorce or legal separation.
- The death of a family member.
- You’re no longer a dependent.
You won’t qualify for a Special Enrollment Period if you chose to drop the coverage you have as a dependent, unless you also had a decrease in household income or a change in your previous coverage that made you eligible for savings on a Marketplace plan.
An employer offer to help with the cost of coverage
Note: Your employer may refer to an individual coverage HRA by a different name, like the acronym “ICHRA.”
More qualifying changes
Other situations that may qualify you for a Special Enrollment Period:
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming a U.S. citizen
- Leaving incarceration
- Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member