Special Enrollment Period

Missed the Open Enrollment Period this year? You don't have to wait until next year if you're eligible for Special Enrollment which offers more flexibility!
Special Enrollment Period

Learn how to get high-quality and affordable insurance coverage outside of open enrollment period.

Knowing about special enrollment periods is important because it provides individuals and families with an opportunity to enroll in a health insurance plan outside of the general open enrollment period. It can help those affected by life-changing events find better coverage that meets their needs without having to wait until open enrollment. Also, there may be government subsidies available during this period which could help lower the cost of premiums. Lastly, special enrollment periods can provide access to certain plans with special rates and additional coverage options.

What Is Special Enrollment Period?

A special enrollment period (SEP) is an opportunity for individuals or families to enroll in a health insurance plan outside of the general open enrollment period. These periods often come about due to life-changing events such as marriage, birth or adoption of a child, loss of employer-sponsored coverage, and other specific circumstances. During a special enrollment period, individuals may be eligible for government subsidies that help lower the cost of premiums. It's important to take advantage of these opportunities to get the best coverage possible.

How Long Is Special Enrollment Period?

Special enrollment periods typically begin 60 days before and continue for up to 60 days after a qualifying life event has occurred. Depending on where you live, the length of the special enrollment period and the types of plans available may vary. If you don't take action within this time period, you may have to wait until the next open enrollment period to make changes to your health plan. It is important to be aware of all deadlines associated with the special enrollment period in order to secure coverage.

What Qualifies You For A Special Enrollment Period?

To qualify for a special enrollment period, you must experience a qualifying life event such as marriage, birth or adoption of a child, loss of employer-sponsored coverage, and other specific circumstances. Depending on the state you live in and the type of health plan you choose, there may be additional qualifying events that grant access to a special enrollment period. Once you qualify for a special enrollment period, it is important to act quickly in order to take advantage of the available plans and subsidies.

How to Special Enrollment Period?

Applying for a special enrollment period is straightforward. You will need to provide necessary documentation such as proof of your qualifying life event and any applicable forms that may be required by your state or health plan. Once you have all the documents ready, you can submit an application online or contact the health insurance company directly to get enrolled in a coverage plan. It's important to make sure that you are enrolled in the correct plan before the special enrollment period ends in order to avoid penalties or missing out on important benefits.

What Happens After Your Application?

After applying for a special enrollment period, you will usually receive a response from your health insurance company within 30 days. They will either approve or deny your application based on the documents that were submitted. If approved, you'll be informed of the next steps such as selecting a plan, paying any applicable fees and starting coverage. If denied, the company should provide an explanation as to why your application was not accepted and what alternative options may be available to you.

Open Enrollment vs Special Enrollment

Open enrollment and special enrollment have different timelines and requirements. Open enrollment typically occurs once a year, at the start of the calendar year, allowing individuals to sign up or change their health plans without needing to provide any documentation. Special enrollment periods are available throughout the year for those who experience a qualifying life event such as marriage, birth of a child or job change; this requires them to provide proof of their life event in order to be eligible for coverage. Both types of enrollments may also require payment of fees and completion of forms.

Common Questions Open Enrollment Special Enrollment
Who is Qualified? Everyone (All U.S. citizens, US nationals or lawfully present immigrants) Only those with a qualified life event
When Can You Apply? During the Open Enrollment window of time Within 60 days of the qualifying life event date

Which one is better? It really depends on your individual situation. Open enrollment is ideal if you are looking to join a health plan or make changes your existing one at the start of a calendar year, as this allows for more control in terms of plan selection and coverage options. On the other hand, special enrollment periods provide more flexibility to those who experience qualifying life events, allowing them to sign up or change plans more quickly than during open enrollment. Ultimately, it is up to each person to decide which option is best for their needs.