Jane Dotson
If you missed the Open Enrollment Period for health insurance, you may still have options for obtaining coverage. In most states, short-term health insurance is available, although it does not meet the Affordable Care Act's (ACA) requirements for minimum essential coverage. Certain life events, such as getting married, moving, losing health coverage, or having a change in income, may qualify you for a Special Enrollment Period (SEP) where you can purchase a health plan outside of the normal Open Enrollment Period. Additionally, Medicaid and CHIP programs offer year-round enrollment for eligible applicants, and some states have their own programs with enrollment periods outside of the standard Open Enrollment. It's important to note that options may vary depending on your state and specific circumstances.
| Characteristics | Values |
|---|---|
| Open Enrollment Period for Individual and Family plans | November 1 to January 15 or 31 |
| Special Enrollment Period | 60 days after a qualifying life event |
| Qualifying life events | Getting married, moving, getting a divorce, losing your job, losing health coverage, having a baby, adopting a child, placing a child for foster care, losing Medicaid or CHIP eligibility, or expiring COBRA coverage |
| Year-round enrollment | Medicaid and CHIP for eligible applicants, including American Indians and Alaskan Natives |
| Other options | Short-term health insurance, standalone dental or vision insurance, Basic Health Programs in New York, Minnesota, and Oregon, The ConnectorCare program in Massachusetts, The Covered Connecticut program |
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What You'll Learn
Qualifying for a Special Enrollment Period
If you missed the Open Enrollment Period and are looking to apply for health insurance, you may qualify for a Special Enrollment Period (SEP). A Special Enrollment Period is a period of time usually 60 days during which you can buy a health plan outside the normal Open Enrollment Period.
To qualify for a Special Enrollment Period, you must have experienced certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child. Losing health coverage could include losing job-based health insurance, losing your Medicaid or CHIP eligibility, or expiring COBRA coverage. If you lose your Medicaid or CHIP coverage, you may qualify for an SEP within 90 days. Losing coverage because you didn't provide the required documents does not qualify you for an SEP.
Additionally, you may qualify for an SEP if your household income is below a certain amount. Consumers with an annual income up to 200% of the Federal Poverty Level ($30,120 for an individual or $62,400 for a family of four in 2025) can qualify for an SEP and access nearly free health plans throughout the year.
It's important to note that the availability of Special Enrollment Periods may vary depending on your state. Some states offer Basic Health Programs or specific programs like the ConnectorCare program in Massachusetts or the Covered Connecticut program, which allow eligible applicants to enroll anytime. American Indians and Alaskan Natives can enroll in exchange plans year-round.
If you don't qualify for a Special Enrollment Period, you may still have other options to consider, such as short-term health insurance plans. However, these plans may not meet the Affordable Care Act's requirements for minimum essential coverage.
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Short-term health insurance
To enrol in a short-term health insurance plan, you can apply directly through a private company like UnitedHealthcare. You will need to answer some short application questions to determine your eligibility for coverage. Keep in mind that short-term health insurance is not available in all states, and some states may impose stricter rules or prohibit the sale of short-term plans altogether.
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Applying for Medicaid or CHIP
If you missed the Open Enrollment Period, you can still apply for Medicaid or CHIP. Medicaid and CHIP enrollment are available all year round for eligible applicants. American Indians and Alaskan Natives can also enroll at any time.
Medicaid provides free or low-cost medical benefits to eligible individuals and families. To apply for Medicaid, you must be a resident of the state where you are applying for benefits. Each state has its own requirements, but eligibility generally depends on a combination of income, household size, family status (such as pregnancy or caring for young children), disability, and age.
To apply, you need to find your state's Medicaid agency and check what documentation they require. You can then create an account with the Health Insurance Marketplace and fill out an application. If it looks like anyone in your household qualifies for Medicaid, your information will be sent to your state agency, and they will contact you about enrollment.
The Children's Health Insurance Program (CHIP) provides low-cost health coverage to children and pregnant women in families that earn too much to qualify for Medicaid. CHIP qualifications vary in every state but typically depend on income. To apply for CHIP, you can create an account with the Health Insurance Marketplace and fill out an application. If anyone in your household qualifies, your state agency will contact you about enrollment.
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Losing job-based health coverage
You can enrol in a Marketplace plan, which may offer savings based on your income and household size. You may also qualify for a tax credit to reduce your monthly insurance payment. If you are unsure about the affordability of a Marketplace plan, you can apply first and find out if you qualify for any savings.
If you are unemployed, you may also be eligible for COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation coverage. This is a federal law that allows you to maintain your previous health coverage temporarily after your employment ends. You can contact the Department of Labor to learn more about COBRA coverage.
In addition to these options, short-term health insurance is available in most states. While it may not provide full-year coverage, it can be a temporary solution to ensure you have some form of health insurance.
Finally, certain states offer specific programs that may be relevant. For example, New Jersey has the GetCoveredNJ program, which allows consumers to enrol outside of the Open Enrollment Period under certain circumstances. Therefore, it is beneficial to check what state-specific programs are available in your area.
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Enrolling in a new state
Moving to a new state can qualify you for a Special Enrollment Period (SEP), allowing you to enrol in health insurance outside of the usual Open Enrollment Period. The Open Enrollment Period typically occurs once a year, from November 1 to either January 15 or 31, depending on the state.
To qualify for an SEP after moving to a new state, you must meet certain criteria. Firstly, ensure you are within the timeframe; you usually have up to 60 days before or after the move to enrol in or change your plan. Secondly, you must have had qualifying health coverage in the past 60 days or expect to lose coverage in the next 60 days due to your move. Losing coverage through an employer or family member because you are no longer a dependent qualifies as a loss of coverage. However, choosing to drop your current coverage does not qualify you for an SEP.
Additionally, specific state programmes and eligibility criteria may apply when enrolling in a new state. For example, the New Jersey Easy Enrollment Health Insurance Program allows uninsured or underinsured residents to indicate their interest in coverage when filing their state income tax returns. They can then receive an invitation to apply and enrol outside of the Open Enrollment Period. Similarly, Washington State offers Apple Health, which does not require a special enrollment period, although you must meet eligibility criteria to enrol.
It is important to note that not all states offer the same programmes or have identical eligibility requirements. Therefore, it is recommended to review the specific rules and programmes of the state you are moving to. Additionally, remember that short-term health insurance is available in most states, providing temporary coverage if you are unable to obtain insurance through other means.
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Frequently asked questions
You can apply for insurance after open enrollment by qualifying for a Special Enrollment Period (SEP). This period is usually 60 days after a qualifying life event, such as getting married, moving, getting a divorce, losing your job, or losing your insurance coverage.
After open enrollment, you can purchase standalone dental or vision insurance plans. Short-term health insurance is also available in most states, but these plans do not meet the Affordable Care Act's requirements for minimum essential coverage.
Qualifying life events include losing your health coverage, getting married, having a baby, adopting a child, or moving to a new coverage area. Losing your Medicaid or CHIP eligibility, or reaching age 26 and losing coverage through a parent's plan are also qualifying events.
To apply for a Special Enrollment Period, you can select the type of coverage you lost and review the details. You may qualify for an SEP if you have lost your coverage or expect to lose your coverage within 60 days. You can then choose a plan and enroll within the specified time frame, typically 60 days.
