An ACA Special Enrollment Period (SEP) is a window outside of the Annual Open Enrollment (Nov 1 – Jan 15) when you can enroll in or switch a Marketplace health plan because of a qualifying life event. SEPs are usually 60 days long, starting the day of the event.
Qualifying life events that trigger an SEP:
Loss of coverage (most common):
- Lost job-based health insurance (you, spouse, or parent)
- COBRA expires (you've used the full 18 or 36 months)
- Lost coverage through a divorce or legal separation
- Aged off a parent's plan (turned 26)
- Lost Medicaid or CHIP eligibility
- Lost coverage through a death in the family
- Lost student health insurance (graduating, withdrawing)
- Plan exits the Marketplace and no replacement plan available
- COBRA premium goes up because your employer stopped subsidizing
Household changes:
- Got married
- Had or adopted a baby
- Got divorced or legally separated AND lost coverage
- Death of a household member
Residence changes:
- Moved to a new ZIP code or county
- Moved to or from a shelter or transitional housing
- Moved to or from school (students)
- Seasonal worker moved to or from where they work and live
- Moved to a new state
(For all moves, you must have had qualifying coverage for at least 1 day in the 60 days before the move — except moves from outside the U.S.)
Other qualifying events:
- Became a U.S. citizen, national, or lawfully present immigrant
- Released from incarceration
- Began or ended AmeriCorps service
- Federally Recognized Tribe member or Alaska Native (can enroll any month, no SEP needed)
- Income changed enough to suddenly qualify for or lose Marketplace subsidies (or move you between Medicaid and Marketplace eligibility)
- Errors in enrollment caused by Marketplace, insurance company, or assister (e.g., enrolled in wrong plan due to website error)
- Domestic abuse or spousal abandonment (special protections apply)
The 60-day window:
- Starts the day of the qualifying event (e.g., the day you lost coverage, got married, moved)
- Ends 60 days later
- Some events let you enroll up to 60 days BEFORE (e.g., losing coverage you know is ending, moving)
- Coverage typically starts the first of the month after you enroll, or sooner for some events (loss of coverage can be retroactive)
Documentation required:
You must usually provide proof of the qualifying event within 30 days of enrolling:
- Loss of coverage letter from former employer or insurer
- Marriage certificate, divorce decree, birth certificate, adoption papers
- Letter showing date of move (lease, utility bill, USPS confirmation)
- Medicaid termination notice
Without documentation, your SEP enrollment can be cancelled.
Special situations:
- Pregnancy itself does NOT qualify for an SEP at the federal level (only some state-based exchanges, like New York, allow it). Birth of the baby DOES qualify.
- Voluntarily dropping employer coverage does NOT qualify — must be involuntary loss.
- COBRA election does NOT qualify as loss of coverage (you chose to continue). The original loss of employment-based coverage is what triggered the SEP — and electing COBRA uses up your SEP.
- Plan year-end is NOT an SEP unless it's combined with another event (Open Enrollment is the standard window for non-event renewals).
"Year-round enrollment" for low-income households:
- If your household income is at or below 150% of FPL, you can enroll in a Marketplace plan any month of the year — no SEP required. (This was made permanent under the IRA.)
- This benefits roughly 5 million low-income Americans who previously had to wait for OE.
What to do next: [Check SEP eligibility in 60 seconds](/aca/), or call (866) 534-1886. If you've had a qualifying event in the last 60 days (or have one coming up), we'll confirm eligibility, gather the documentation you need, and enroll you in the right plan. Free.