The open enrollment period for health coverage through Health Insurance Marketplace runs through November 1st to December 15th every year. Individuals and families who qualify can get health coverage through either healthcare.gov or their state’s marketplace.
As for 2021, most states use the federal marketplace, healthcare.gov. If you’re living in any of the following states, you must get coverage from your state’s own marketplace site.
- District of Columbia
- New York
- Rhode Island
The federal open enrollment period is the same whether your state operates its own marketplace or not. Missed the open enrollment period? See if you qualify for the SEP.
Special Enrollment Period (SEP)
To qualify for the Special Enrollment Period to enroll in health coverage through the Marketplace, you must have certain life events. All of these life events must have occurred in your household in the past 60 days. Beyond that, you simply cannot enroll in health coverage and must wait for the next open enrollment.
SEP Life Events
The following table shows the life events that can make you qualify for the SEP.
|Death||If someone in your Marketplace dies and you lost your insurance because of that, you qualify for the SEP.|
|Marriage||If you got married, you qualify for the SEP. Choose your plan by the last day of the month within 60 days of marriage and your plan will automatically start the next month.|
|Divorce||Legal separation or divorce resulting in losing health coverage qualify for the SEP. Still have your coverage after separation? Unfortunately, you must wait for the next open enrollment period.|
|Having a Child||If you had a child, adopted a child, or placed a child for foster care, you qualify for the SEP. The 60-day limit doesn’t apply to this so you can enroll in coverage even after the days are due.|
SEP Moving to a New Residence
Also, if you moved to a new residence, you may qualify for the Special Enrollment Period. This applies to students well as you’re likely to move to a place you attend school. The seasonal employees can also benefit from this upon moving to or from the place of living or work.
When you have insurance and move to a new home in a new county or ZIP code, you also qualify for the Special Enrollment plan. In general, you get to purchase new government-subsidized health coverage when you move to a new residence. This, of course, if the new residence is in another ZIP code or county than the previous place.
Qualifying for Health Coverage
Once you get to healthcare.gov or your state’s Marketplace to compare plans, you must enter a few information about your household. This information includes the number of people in the household and household income. Depending on these, you will find whether you qualify for enrollment or not.
All areas have their own different income requirements. Therefore, while you qualify for coverage in your county, another person or household in the next county with a similar income may not qualify. So it’s best to make sure you qualify for purchasing government-subsidized health coverage through Marketplace first.