What triggers a Special Enrollment Period?
- Losing job-based health coverage (your own or a family member's)
- Getting married or divorced
- Having a baby, adopting, or placing a child for foster care
- Moving to a new ZIP code or new state
- Turning 26 and aging off a parent's plan
- Becoming a U.S. citizen or lawfully present resident
- A change in income that affects your subsidy eligibility
- Leaving incarceration
The 60-day rule
You have 60 days from the date of your qualifying event to enroll in a marketplace plan through your SEP. Miss the 60-day window and you generally have to wait until the next Open Enrollment to get coverage. Some events also let you enroll up to 60 days before the event (a planned move, for example), so coverage can start the moment the event happens.
What you'll need to prove the event
The marketplace usually asks for documentation — a termination letter from your former employer, a marriage certificate, a birth certificate, a lease or utility bill at your new address. Your Marketplace Hubs agent will tell you exactly which document the marketplace will accept for your specific event.
When does new coverage start?
For most SEP enrollments, coverage starts the first of the month after you select a plan. For births, adoptions, and marriages, coverage can be backdated to the event date if you enroll within the window. Job-loss SEPs can sometimes start coverage retroactively to fill the gap.