Special Enrollment Period

Enrolling outside the yearly window

ACA-compliant plans can normally only be purchased during open enrollment. A special enrollment period, or SEP, is the exception. When something major changes in your life, the rules open a window for you to sign up or switch plans.

In most cases you have 60 days from the event to enroll. For some events, like an expected loss of coverage, you can also apply up to 60 days before the event so there is no gap.

Common events that trigger an SEP

• Losing job-based coverage, COBRA ending, or aging off a parent's plan at 26.
• Getting married.
• Having a baby, adopting or placing a child in foster care.
• Moving to a new ZIP code or county with different plan options, if you had coverage before the move.
• Gaining citizenship or lawful presence.
• Certain changes in income that affect subsidy eligibility.

Voluntarily dropping coverage or losing it for not paying premiums does not count.

Example

Andre leaves his salaried job on March 31 to start his own consulting firm. His employer coverage ends that day.

• He can apply for a Marketplace plan as early as February, up to 60 days before the loss of coverage, so his new plan starts April 1 with no gap.
• If he waits until after March 31, he still has 60 days, through late May, to enroll.
• He may need to provide proof, such as a letter from his employer showing the coverage end date.

If he misses the 60-day window, he would generally have to wait until open enrollment or look at private plans that accept applications year-round.

When coverage starts

For most SEPs, coverage begins the first day of the month after you pick a plan. For birth or adoption, coverage can be backdated to the date of the event.

Changes for 2027

The monthly SEP that let people under 150% of the federal poverty level enroll any time is gone for 2027. For everyone else, the standard qualifying events still apply, and the Marketplace may ask for documentation to verify eligibility.

Marketplace vs private plans

SEPs matter for ACA-compliant plans, on and off the exchange. Private underwritten plans typically accept applications any time of year, so they do not require an SEP, though they may ask health questions. If you have a qualifying event and a health condition, using your SEP for an ACA plan is usually the safest choice.

Tips

• Mark the event date and count 60 days forward.
• Gather documents early: termination letters, marriage certificate, lease or utility bill for a move.
• Do not wait until the last week.

See our detailed guide to the special enrollment period in Florida and what to do if you missed open enrollment. If you have a recent life event, request a quote and Frank can help you act within the window.