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What is a Special Enrollment Period (SEP)?

A Special Enrollment Period is a time outside the regular open enrollment period during which individuals can enroll in or change their health insurance plans. SEPs are triggered by specific life events that impact your health coverage needs.

What qualifying life events can trigger a Special Enrollment Period?

Common qualifying life events include: - Losing your health coverage - Moving to a new zip code - Getting married - Having a baby or adopting a child - Becoming a U.S. citizen or lawful resident - Leaving incarceration (jail or prison) - Changes in your household, such as divorce or death of the policyholder These events can allow you to enroll or switch health plans outside the standard enrollment period.

How long does the Special Enrollment Period last?

The duration of the SEP generally lasts 60 days after the qualifying life event.

What if I miss the Special Enrollment Period?

If you miss the 60-day window to enroll during an SEP, you will need to wait until the next open enrollment period to apply for coverage unless you experience another qualifying event.

Can I qualify for a Special Enrollment Period if I have health coverage through my employer?

Yes, if you have health coverage through your employer, but you experience a qualifying life event, you may still be eligible for a Special Enrollment Period to enroll in a Marketplace plan or adjust your current plan.

Are Special Enrollment Periods the same for Medicaid and CHIP?

No, the rules for Medicaid and the Children's Health Insurance Program (CHIP) are different. Medicaid and CHIP enrollments are open year-round, allowing you to apply or renew whenever you meet the eligibility requirements.

What if I have a planned change in health insurance during my Special Enrollment Period?

You can choose to change your health insurance plan during the SEP even if you have a planned change. Make sure to carefully review coverage options and how they fit your health care needs.

Open enrollment is the designated time of year when individuals can enroll in, change, or renew their health insurance plans. It is the primary opportunity for most people to obtain or adjust their coverage. This year open enrollment is November 1st to January 15th.

You may be able to get insurance outside this timeframe if you meet certain criteria. These are called Special Enrollment Periods (SEP).

To find out if you are eligible, give us a call: 817-350-6265

Here are some questions you may have regarding SEPs: