What Is a Special Enrollment Period and How Can It Help You Get Health Insurance?

As of Jan. 16, 2024, open enrollment for 2024 health insurance has ended. But that doesn’t mean it’s impossible to get health insurance for the rest of the year. If you have certain changes in your job situation or personal life, you can still get health insurance for 2024.

Getting health insurance outside of open enrollment is called a “special enrollment period.” But not everyone is allowed to use this option to get health insurance coverage. There are certain rules and restrictions on who can get a special enrollment period.

Let’s look at how special enrollment periods work, and how you can use this alternative way to get health insurance in 2024.

Special enrollment period vs. open enrollment

If you get health insurance through your job, you’re probably familiar with open enrollment. This is a special time of year when people can sign up for employee benefits or make changes to their insurance plans. Depending on your employer, your open enrollment period might be a few weeks during the autumn — companies use this time to make sure employees are signed up, announce changes to benefits and insurance options for the new year ahead, and offer new options.

If you have your own small business or are self-employed, or otherwise do not have job-based health insurance for yourself or through your spouse, you can also use the open enrollment period on HealthCare.gov. This open enrollment typically goes from Nov. 1-Jan. 15, and it gives you time to sign up for health insurance for the first time if you don’t have coverage, re-enroll in your current coverage, or choose a new plan.

If everything in your life is staying the same for now, open enrollment is a pretty straightforward experience. You can keep your current plan, or make changes to your plan based on the options available at your job or on the HealthCare.gov marketplace.

But if you’re having big changes in your life that happen at some time of year other than open enrollment, you still deserve to get health insurance! This is where a special enrollment period can help you. A special enrollment period is a special opportunity to sign up for new health insurance or change your plan. You can change insurance any time of year, as long as you qualify for a special enrollment period.

Special enrollment periods: How to get one

To qualify for a special enrollment period, you need to have a qualifying life event (QLE). These events are usually related to changes in your income, your employment, or your family.

Here are a few common types of qualifying life events:

  • You lose your job-based health insurance (or the insurance you used to get through a family member’s job, such as a spouse’s job) — this could be a result of quitting your job or being laid off
  • Your individual health insurance plan gets discontinued or canceled
  • Your household income has decreased to the extent that you now qualify for savings on a HealthCare.gov marketplace plan
  • You or your family has lost eligibility for Medicaid or a state Children’s Health Insurance Plan (CHIP)
  • You get married, or get legally separated or divorced (and lose health insurance coverage as part of the divorce/separation)
  • You have a new baby, adopt a child, or place a foster child — you can get insurance coverage starting from the first day of your new child’s life with your family, even if you enroll up to 60 days later

If you are leaving your job for a new company with job-based health insurance, and you do not have any interruption of health insurance coverage, you do not need a special enrollment period. For example, if your last day at your previous job was July 15, your former insurance continues through July 31, and your new company’s health insurance will cover you from your first day on the job on Aug. 1, you don’t need a special enrollment period.

But if you are leaving your job to start a small business, if you have been laid off and don’t want to pay for high-priced COBRA insurance premiums, or if you have other life changes and situations that have caused you or your family to lose your previous health insurance coverage, you might need a special enrollment period.

If you think you have experienced a qualifying life event, start by going to HealthCare.gov to see if you can get health insurance. There is a quick questionnaire you can fill out to see if your situation makes you eligible for a special enrollment period.

Bottom line: The end of open enrollment is not your only chance to get health insurance for 2024. If you have a qualifying life event like leaving a job, having a change of marital status, welcoming a new child to your family, or certain changes in household income, you can get a special enrollment period to sign up for health insurance at any time of year. Go to HealthCare.gov to see if you can get health insurance.

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