A Special Enrollment Period (SEP) lets you sign up for or change Marketplace health insurance outside open enrollment after a qualifying life event, such as losing other coverage, getting married, having a baby or moving. On HealthCare.gov you usually have 60 days after the event to pick a plan, and for some losses of coverage you can also apply up to 60 days before. Medicaid and CHIP have no enrollment window at all, so you can apply any day of the year.
Timing and paperwork decide whether an SEP works for you. Miss the window by a week and you may be stuck until the next open enrollment. Below are the events that qualify, the windows and start dates for each, the documents HealthCare.gov asks for, and the rules that changed for 2026.
Qualifying life events and their windows
The table covers HealthCare.gov states. States that run their own Marketplace follow similar rules but can set longer windows, so check your state’s site.
| Event | When you can enroll | Prior coverage needed? | Coverage usually starts |
|---|---|---|---|
| Losing job-based coverage, COBRA ending, aging off a parent’s plan at 26 | 60 days before or 60 days after the loss | Yes (that’s the event) | First of the month after the old coverage ends, or after you pick a plan |
| Losing Medicaid or CHIP | 60 days before or up to 90 days after | Yes (that’s the event) | First of the month after the loss or plan selection |
| Marriage | 60 days after | At least one spouse had coverage for 1 day in the prior 60 days (with exceptions) | First of the month after you pick a plan |
| Birth, adoption, foster placement | 60 days after | No | The date of the event (can be backdated) |
| Permanent move to a new ZIP code or county | 60 days after | Yes, 1 day in the prior 60 days (with exceptions) | First of the month after plan selection |
| Gaining lawful presence or release from incarceration | 60 days after | No | First of the month after plan selection |
| Employer offers an individual coverage HRA | Generally 60 days before the HRA start date | No | HRA start date or first of the next month |
Other events can qualify too, including an income change that makes you newly eligible for savings, divorce that causes loss of coverage, or exceptional circumstances like a serious illness or natural disaster that kept you from enrolling. Those exceptional cases are handled by the Marketplace Call Center at 1-800-318-2596.
What doesn’t count
- Dropping coverage voluntarily, or losing it because you stopped paying premiums.
- Simply wanting a different plan or realizing your doctor isn’t in network.
- Getting sick or needing a procedure.
- A temporary move, like a vacation or a short work assignment.
- Low income on its own. The SEP that once let people at or below 150% of the federal poverty level enroll any month was eliminated nationwide on August 25, 2025, and a 2026 federal rule ended it permanently.
The One Big Beautiful Bill Act also bars premium tax credits, starting in 2026, for anyone who enrolls through an income-based SEP that isn’t tied to a life event. If you qualify through an actual life event, subsidies still apply.
How to use a Special Enrollment Period
- Write down the exact date of your event, such as the last day of employer coverage or your wedding date. Your 60-day clock runs from it.
- Go to HealthCare.gov or your state Marketplace, start or update an application and answer the life event questions.
- Choose a plan before the window closes. If you already have a Marketplace plan, you may be limited to plans at the same metal level for some events.
- Upload the documents the Marketplace requests within 30 days of choosing a plan. Coverage can be held (“pended”) until they’re reviewed.
- Pay the first month’s premium directly to the insurer once eligibility is confirmed. Coverage doesn’t start until that payment is made.
- Watch your Marketplace account and mail for any request for more information.
Example: Carlos’s last day at work is June 14, and his employer coverage ends June 30. He can apply on HealthCare.gov as early as May 1 (60 days before the loss) and pick a plan by the end of June so that new coverage starts July 1 with no gap. If he waits, he still has until August 29 (60 days after the loss), but coverage would start the first of the month after he picks a plan, leaving him uninsured for July or longer.
Documents the Marketplace may ask for
Pre-enrollment verification on HealthCare.gov applies mainly to the loss-of-coverage SEP. A federal court in July 2026 stayed a broader rule that would have required checking at least 75% of new SEP enrollments, so verification is now limited to that SEP. Other events can still trigger requests for proof, and state Marketplaces set their own rules. Keep these ready:
- Loss of coverage: a letter from the employer or insurer showing the end date, a COBRA notice, or a Medicaid or CHIP termination notice.
- Marriage: a marriage certificate, plus proof that one spouse had qualifying coverage in the 60 days before.
- Birth or adoption: a birth certificate, hospital record, adoption or foster placement papers.
- Move: a lease, mortgage statement, utility bill or official mail showing both the old and new address and dates, plus proof of prior coverage.
- Release from incarceration: release papers showing the date.
If a document doesn’t exist yet (a birth certificate can take weeks), upload what you have, like a hospital record, and add the rest later. Send copies, not originals.
Medicaid and CHIP: any time of year
Medicaid and the Children’s Health Insurance Program don’t use enrollment periods. If your income drops or your household grows, you can apply on HealthCare.gov or through your state Medicaid agency the day it happens. Some states can make coverage retroactive for recent medical bills, though the rules vary and several states have narrowed it.
Example: Aisha’s hours are cut in October, and her monthly income falls below her state’s Medicaid limit for a household of three. She doesn’t need to wait for an event or open enrollment. She applies in October, and her children may qualify for CHIP even if she doesn’t qualify for Medicaid. If she later earns too much for Medicaid, losing it gives her a Marketplace SEP of up to 90 days afterward.
Employer plans have their own special enrollment rules
Job-based plans also allow mid-year enrollment after events like marriage, birth, adoption or losing other coverage, but the federal minimum window is shorter: 30 days. For losing Medicaid or CHIP, or becoming eligible for state premium help, the window is 60 days. Some employers allow more time. If you’re adding a newborn or spouse to a work plan, contact HR right away rather than assuming you have 60 days.
Example: Jordan and Lee marry on March 10. Lee’s job offers family coverage. They have until April 9 to add Jordan to the employer plan. If they miss it, Jordan could still use the Marketplace marriage SEP until May 9, as long as one of them had qualifying coverage in the 60 days before the wedding.
Common questions
How long is a Special Enrollment Period?
On the Marketplace it’s usually 60 days after the qualifying event, and for some coverage losses you can also apply up to 60 days before. Losing Medicaid or CHIP gives you up to 90 days after. Employer plans are often limited to 30 days.
Is losing my job a qualifying life event?
Losing the health coverage that came with the job is. Your window runs from the date the coverage ends, which is often the end of the month after your last day. Voluntarily dropping COBRA mid-term doesn’t qualify, but COBRA running out does.
Can I enroll in Medicaid outside open enrollment?
Yes. Medicaid and CHIP accept applications all year. If you qualify, coverage can start right away and sometimes covers recent months.
What if I miss the 60-day window?
You’ll generally have to wait for the next open enrollment period unless another qualifying event happens. If something outside your control kept you from enrolling, ask the Marketplace Call Center about an exceptional circumstances SEP.
Is turning 26 a qualifying event?
Yes. Aging off a parent’s plan is a loss of coverage, so you can enroll from 60 days before to 60 days after that coverage ends.
Before you apply
- Pin down the exact date of your qualifying event and count 60 days.
- Apply before a coverage loss if you can, to avoid a gap.
- Gather documents for your event, plus proof of prior coverage if needed.
- Check Medicaid and CHIP eligibility if your income has dropped.
- Pay the first premium promptly once your plan is confirmed.
HealthCare.gov has a screener for special enrollment eligibility.
Editorial note: This article is general information, not insurance or legal advice. Rules were checked as of November 2026; confirm your windows and documents with HealthCare.gov, your state Marketplace or your Medicaid agency.