Open enrollment is the main time to buy health insurance, but it is not the only time. If something major changes in your life, you may qualify for a Special Enrollment Period that lets you sign up or switch plans outside the usual window. Here is how it works and who qualifies.

What is a Special Enrollment Period?

A Special Enrollment Period is a window, usually 60 days, that opens after a qualifying life event. During that time, you can enroll in a marketplace plan even if open enrollment has ended. If you lose Medicaid or CHIP, most states give you 90 days.

For some events, such as losing other coverage, you can also enroll up to 60 days before the event happens. That can help you avoid any gap in coverage.

Life events that can qualify you

Losing health coverage, such as job-based insurance, Medicaid or CHIP
Getting married
Having a baby, adopting a child or placing a child in foster care
Moving permanently to an area with different plans
Divorce, legal separation or a death in the family that causes you to lose coverage
A change in income that affects your eligibility for savings
Your employer's coverage becoming unaffordable
An employer offering an individual coverage health reimbursement arrangement (ICHRA)

Quitting a plan voluntarily or simply missing the deadline does not count. If you qualify because you lost coverage, you will usually need to show proof.

When your coverage starts

Coverage usually starts on the first day of the month after you enroll. If you have a baby or adopt a child, coverage can be backdated to the date of the birth or adoption.

Options that are open all year

Medicaid and CHIP: If your income is low enough, you can apply at any time.
Some state programs: A few states, including Minnesota, Oregon, New York and Massachusetts, run programs with their own enrollment rules. Check your state's marketplace.

One option has gone away. The year-round enrollment window that allowed people with very low incomes to sign up any month is no longer available, and it is permanently barred for 2027 and beyond.

What to do if you don't qualify

Check whether you qualify for Medicaid or CHIP. Eligibility rules vary by state.
Ask about job-based coverage. A new job or a spouse's employer plan may have its own enrollment window.
Mark your calendar. The next open enrollment starts on November 1. Enroll by December 15 for coverage that starts January 1.
Be careful with alternatives. Short-term plans and other non-marketplace options often exclude pre-existing conditions and may not cover essential care. Read the details before you buy.

The bottom line

Missing open enrollment does not always mean waiting a full year. A move, a new baby, a marriage or losing other coverage can all open a 60-day window. Act quickly when your life changes, because once that window closes, you may have to wait until the next open enrollment.