Special Enrollment: the 60-day window
Outside Open Enrollment the marketplace is shut unless something has changed in your life. The clock starts at the event, not when you find out.
Outside Open Enrollment the marketplace is closed, with one exception: a qualifying life event opens a 60-day Special Enrollment Period. The clock starts at the event, not when you notice it, and it does not pause while you decide.
What counts as a qualifying event
Losing coverage you already had
The most common route in, and the one with a feature the others do not have: for loss of coverage the window runs 60 days either side of the loss. You can enroll before the coverage ends, which is how you avoid a gap rather than merely surviving one.
- Leaving a job, whether you chose to or not
- Hours cut below your employer's eligibility threshold
- Turning 26 and aging off a parent's plan — more on this one
- Losing Medicaid or CHIP eligibility
- COBRA coverage running out at the end of its term
- A divorce or legal separation that ends coverage under a spouse's plan
Choosing to drop coverage does not qualify. Neither does losing it for not paying premiums. Ending COBRA early by stopping payment is not a qualifying event; letting it run to its natural end is.
Household changes
- Marriage — coverage generally starts the first of the month after you pick a plan
- Having a baby, adopting, or a foster placement — coverage is backdated to the date of the birth or placement
- Divorce or legal separation, where it causes a loss of coverage
- A death in the household that changes eligibility
Moving
A permanent move to a new ZIP code or county where different plans are available qualifies — but only if you already had coverage for at least one of the 60 days before the move. Moving for medical treatment or a vacation does not count.
This is worth pausing on, because it is the event where the county data on this site matters most directly: moving changes your rating area, which changes which insurers will sell to you and what the benchmark plan costs. Compare the county you are leaving with the one you are going to.
Less common, still qualifying
- Becoming a US citizen or gaining lawful presence
- Leaving incarceration
- A change in income that alters your eligibility for a credit
- Leaving AmeriCorps, VISTA or NCCC service
- A marketplace or insurer error that affected your enrollment
Expect to prove it
Most Special Enrollment Periods now require documentation, and coverage can be held until you supply it. Have the paperwork ready rather than hunting for it with days left on the clock:
- Loss of coverage: a letter from the employer or insurer showing what ended and on what date. A COBRA election notice works.
- Marriage: the certificate.
- Birth or adoption: birth certificate or placement papers.
- Moving: a lease, mortgage document or utility bill at the new address, plus evidence of prior coverage.
The 60 days are calendar days, not business days, and the window closes whether or not anyone has told you it exists. If something on this page has happened to you, the useful thing to do is work out today's date relative to the event before doing anything else.
When coverage actually starts
It varies by event, which surprises people:
- Birth or adoption: backdated to the date of the event.
- Loss of coverage, enrolled in advance: the first of the month after the old coverage ends, so there is no gap.
- Most other events: the first of the month after you select a plan.