Marketplace/Affordable Care Act (ACA) SEPs:
ACA Special Enrollment Periods (SEPs) allow individuals and families to enroll in, change, or update their Marketplace health insurance outside of the Open Enrollment Period if they experience a qualifying life event.
Some of these QLEs include:
Losing Health Coverage: People who lose job-based coverage, Medicaid, CHIP, or individual health insurance.
You have 60 days before and 60 days after the coverage loss.
Changes in Household: If you get married, have a baby, adopt a child, or experience a death that affects your coverage.
You have 60 days after the event.
Changes in Residence: If you move to a new ZIP code or county, move to the U.S. from abroad, move to or from a shelter, or leave incarceration.
You have 60 days after the move.
Changes in Income or Eligibility: If your income changes and makes you newly eligible (or ineligible) for Marketplace subsidies or Medicaid.
You have 60 days after the income change.
Gaining Citizenship or Lawful Presence
Who qualifies? If you become a U.S. citizen or gain lawfully present status.
How long? 60 days after gaining status.
Special Circumstances (e.g., Natural Disasters, Errors, Domestic Abuse)
Who qualifies? If a FEMA-declared emergency, Marketplace error, or personal hardship (like domestic violence) prevents timely enrollment.
How long? Varies, but typically 60 days after the qualifying event.
If you have any additional questions, contact our team today!
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