What is a Special Enrollment Period?

Each year during Open Enrollment, you hear it… “If you don’t act by December 15, you can’t get health insurance coverage unless you qualify for a Special Enrollment Period.” Well, what exactly does this mean – what is a Special Enrollment Period & what does it mean for you & your family?

Simply put, a Special Enrollment Period is a time outside of the annual Open Enrollment Period when you can sign up for health insurance. Now, it is important to understand if you miss Open Enrollment that doesn’t mean you can just sign up another time of the year & it will be considered a Special Enrollment. See, in order to get or change health insurance after Open Enrollment, you must qualify for a Special Enrollment Period. To qualify, you must have experienced certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.

If you qualify for a SEP, you usually have up to 60 days following the event to enroll in a plan or change your existing coverage. If you miss that window, you have to wait until the next Open Enrollment Period to apply or select a different plan. However, there is one exception, if you (or your family) are eligible for Medicaid or the Children’s Health Insurance Plan (CHIP) you can enroll in these programs any time of year, whether you qualify for a Special Enrollment Period or not. Another rule to note is that job-based plans must provide a special enrollment period of at least 30 days.

So are you wondering, “Do I qualify for a Special Enrollment Period?” The best way to determine this is to give us a call & one of our licensed agents will ask you a few questions to determine if you qualify for a Special Enrollment Period.

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(800) 601-0543


Reference: HealthCare.gov. (2019). Get Marketplace health coverage outside Open Enrollment only with a Special Enrollment Period. Retrieved from https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/