Do I qualify for a Special Enrollment Period?
You don’t always need to wait for open enrollment to sign up for health insurance. Read on to learn more.
There are two types of enrollment for health insurance: Open Enrollment and Special Enrollment Period. Here’s an explanation of each.
What is a Special Enrollment Period?
To enroll in a health insurance plan during a Special Enrollment Period, you must have had a Qualifying Life Event (QLE) — and you must document it within 30 days. You have 60 days from the qualifying event to enroll, so be sure to move quickly and shop now.
If you’re not sure if you qualify, call us at 800-223-1282. We can help.
What are Qualifying Life Events?
If you’ve experienced any of these Qualifying Life Events in the past 60 days, you’re eligible to enroll in a health plan during a Special Enrollment Period (SEP):
Changes in household size
- Got married
- Had a baby
- Gained/became a dependent
- Got divorced or legally separated and lost health insurance
- Death
Changes in residence or income
- Change in your primary place of living
- Had a change in income
Change in status
- Denied Medicaid/CHIP
- Gained citizenship or lawful presence in the U.S.
- Released from incarceration (detention, jail or prison)
More qualifiers
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
- You may qualify for a Special Enrollment Period if you or anyone in your household newly gained access to an individual coverage HRA or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days OR expects to in the next 60 days.
- Note: Your employer may refer to an individual coverage HRA by a different name, like the acronym “ICHRA.”
What is Open Enrollment?
Open Enrollment is the time when you can enroll in a health insurance plan. For 2025 coverage, Open Enrollment begins Friday, Nov. 1, 2024 and runs through Wednesday, Jan. 15, 2025. If you enroll between Nov. 1, 2024 and Dec. 15, 2024, your health coverage will take effect on Jan. 1, 2025. Enroll between Dec. 16, 2024 and Jan. 15, 2025 for coverage starting Feb. 1, 2025.
What happens if I miss Open Enrollment?
After Open Enrollment, if you have a change in your circumstances, called a Qualifying Life Event (QLE) – such as losing your current coverage, getting married, having a baby or moving to a different zip code in Pennsylvania – you may be eligible for a Special Enrollment Period (SEP). If eligible, the SEP lets you enroll in health insurance outside of the yearly Open Enrollment period. See if you qualify.