Orlando Harmon
If you missed the January 31 deadline to get medical insurance, you can still enroll if you qualify for a Special Enrollment Period (SEP). A Special Enrollment Period is a period of time outside of Open Enrollment when you can enroll in or change your Marketplace plan. You can qualify for an SEP if you experience a significant life change, such as getting married, moving to a new coverage area, losing job-based health coverage, or having a baby. Additionally, consumers with an annual income below a certain threshold can qualify for an SEP and access nearly free health plans throughout the year. To get ready for the next Open Enrollment period, sign up for email reminders to stay informed about important dates and deadlines.
| Characteristics | Values |
|---|---|
| Open Enrollment Period | November 1 to January 15 in most states |
| Open Enrollment Period in California, New Jersey, and New York | November 1 to January 31 |
| Open Enrollment Period in Idaho | October 15 to January 15 |
| Open Enrollment Period in Virginia | November 1 to January 22 |
| Open Enrollment Period in Massachusetts | November 1 to January 23 |
| Deadline for full-year coverage starting January 1 | December 15 (5 am EST on December 16) |
| Deadline for coverage starting February 1 | January 15 |
| Special Enrollment Period | Available for consumers based on life-changing events, income level, or exceptional circumstances |
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What You'll Learn
Qualifying for a Special Enrollment Period
Open enrollment for individual/family health coverage for 2025 has ended in most states by January 15, with some exceptions ending on January 22, 23, and 31. To enroll in 2025 coverage, you will need to qualify for a Special Enrollment Period (SEP).
You can qualify for a Special Enrollment Period if you have experienced certain life events, including:
- Losing health coverage, such as job-based, individual, and student plans, or losing eligibility for Medicare, Medicaid, or CHIP.
- Losing coverage due to a change in household income or a family member losing health coverage.
- Turning 26 and losing coverage through a parent's plan.
- Moving to a new coverage area, including moving to the U.S. from a foreign country or U.S. territory, or moving to or from the place you attend school.
- Getting married, divorced, or legally separated.
- Having a baby or adopting a child.
- Experiencing a serious medical condition, natural disaster, or other state-level emergency that prevented you from enrolling on time.
- Gaining a new dependent or becoming a dependent of someone else due to a court order.
- Being a survivor of domestic abuse/violence or spousal abandonment and wanting to enroll in a separate health plan.
If you qualify for an SEP, you usually have up to 60 days after the event to enroll or change your plan. It is important to note that you will not qualify for an SEP if you lost coverage due to failing to provide required documents or choosing to drop your coverage.
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Short-term health plans
Open enrollment for individual/family health coverage for 2025 has ended nationwide. Typically, open enrollment happens once a year, from November 1 to January 31, and is the only time you can enroll in coverage unless you have a qualifying life event or meet a certain income level.
If you are seeking to get medical insurance after January 31, you may want to consider short-term health insurance, also called temporary health insurance. Short-term health insurance is meant to cover your medical bills for a short time, often during a gap in other insurance coverage. It can provide fast, flexible, and temporary health insurance coverage that fits your needs. It is important to note that short-term health insurance only provides limited coverage compared to traditional health insurance, and insurers can charge more or even deny applicants with pre-existing medical conditions.
The duration of short-term health plans is subject to federal rule-making, and different administrations have changed regulations several times. In June 1997, federal regulations restricted short-term health insurance contracts to a maximum of 12 months of coverage. Then, in January 2017, the maximum duration was shortened to up to three months of coverage. In October 2018, the maximum duration was increased back to up to 12 months, and plans could be renewed for up to 36 months. However, in March 2024, the Biden administration instituted a rule limiting short-term health insurance to four months at most if purchased on or after September 1, 2024. This rule includes renewals, so the total duration is limited to four months.
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State-run exchanges with deadlines after January 15
Open enrollment for individual/family health coverage for 2025 has ended in most states. To enroll in 2025 coverage, you will need to qualify for a Special Enrollment Period (SEP). This is true for both on-exchange and off-exchange major medical coverage. Open enrollment began in nearly every state on November 1, and in most states, it ended on January 15. However, there are some state-run exchanges with deadlines after January 15.
In California, New Jersey, and New York, open enrollment ended on January 31. Additionally, in Virginia, open enrollment ended on January 22 after a last-minute extension, and in Massachusetts, it ended on January 23.
If you qualify for an SEP, you usually have up to 60 days after the event to enroll or change your plan. Certain life-changing events, such as getting married, moving to a new coverage area, losing job-based health coverage, or having a baby, qualify you for an SEP and allow you to enroll in coverage with an earlier effective date.
You also have the option to buy a short-term plan, depending on your location, but these plans have limitations and may not provide ACA-compliant coverage.
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Medicaid and CHIP enrollment
If you missed the January 31 deadline to apply for health insurance, you may still be able to get coverage through Medicaid or the Children's Health Insurance Program (CHIP). These programs have no limited enrolment windows and accept applications all year round.
Medicaid and CHIP are government-funded health insurance programs that provide coverage for individuals and families who meet certain eligibility requirements. These programs are available in all 50 states and the District of Columbia, and they offer a range of comprehensive benefits, including emergency care, family planning services, and more.
To apply for Medicaid or CHIP, you can visit your state's official website or the website of your state's health insurance marketplace. You will need to provide information about your household size, income, and current health coverage status. In some cases, you may also be asked to provide documentation to verify your identity and eligibility.
It's important to note that eligibility requirements and coverage options may vary by state. However, certain life-changing events, such as losing job-based health coverage, moving to a new state, or experiencing a change in income, may qualify you for special enrolment periods or expanded coverage options. Additionally, if you are already enrolled in a Medicaid or CHIP plan and your circumstances change, you may be able to make changes to your existing coverage.
As of November 2024, there were approximately 79,034,066 people enrolled in Medicaid and CHIP across the United States, with 37,517,916 of those being children. This highlights the importance and reach of these programs in providing essential health coverage to individuals and families in need.
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Qualifying life events
Open enrollment for individual/family health coverage for 2025 has ended in most states by January 15, with some exceptions running until January 31. However, if you've experienced a qualifying life event, you may be eligible for a Special Enrollment Period (SEP) to enroll in a health plan outside of the annual enrollment period.
A qualifying life event is a life-changing situation that can impact your health insurance. These events include but are not limited to:
- Loss of health coverage: This includes losing job-based health coverage, individual or student plans, or losing eligibility for Medicare, Medicaid, or CHIP.
- Change in residence: Moving to a new coverage area where your current health plan is unavailable or where new plans are available. This could be moving to a different zip code, county, state, or from a foreign country to the US.
- Change in family or household composition: Gaining or losing a dependent through birth, adoption, marriage, or divorce.
- Change in employment status: This includes being laid off, dismissed, resigning, quitting, or retiring.
- Turning 26: Aging out of a parent's health insurance plan.
- Turning 65: Becoming eligible for Medicare.
- Exceptional circumstances: Natural disasters, medical issues, or public health emergencies may also qualify you for an SEP.
If you experience a qualifying life event, you typically have up to 60 days before or after the event to enroll or change your plan. You may be required to provide documentation, such as birth certificates, adoption records, marriage licenses, divorce paperwork, death certificates, rental agreements, or deeds, depending on the event. Contact your health insurance provider to understand your options and the specific requirements for your situation.
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Frequently asked questions
You can only sign up for ACA-compliant health coverage after January 31 if you qualify for a Special Enrollment Period.
A Special Enrollment Period (SEP) is a period of time outside of Open Enrollment when you can enroll in or change Marketplace plans due to a qualifying life event or meeting a certain income level.
Qualifying life events include but are not limited to getting married, moving to a new coverage area, losing health coverage, having a baby, or adopting a child.
A Special Enrollment Period typically lasts for 60 days after the date of your qualifying event.
If you don't qualify for a Special Enrollment Period, you might consider a short-term health plan. However, it's important to note that short-term plans do not meet the Affordable Care Act's requirements for minimum essential coverage. Additionally, you can look into state-specific options or Medicaid and CHIP eligibility.
