Enrolling
Getting covered outside open enrollment
Certain life events reopen the door for 60 days. Here is the list, the proof usually required, and the one route that closed permanently.
Outside the annual window you generally cannot buy a Marketplace plan. The exception is a qualifying life event, which opens a special enrollment period of usually 60 days. Medicaid and CHIP are different: they have no window at all and can be applied for on any day of the year.
Qualifying life events
| Event | Window | Proof usually required |
|---|---|---|
| Losing job-based coverage | 60 days before and after | Letter from employer or insurer with the end date |
| Losing Medicaid or CHIP | 60 days before and after | Termination notice from the state |
| Turning 26 and leaving a parent's plan | 60 days before and after | Insurer notice |
| Exhausting COBRA | 60 days after | COBRA exhaustion notice |
| Marriage | 60 days after | Marriage certificate |
| Divorce, where it ends your coverage | 60 days after | Divorce decree and loss of coverage notice |
| Birth or adoption | 60 days after | Birth certificate or adoption papers |
| Permanent move to a new coverage area | 60 days after | Proof of prior coverage and both addresses |
| Becoming a citizen or lawfully present | 60 days after | Immigration documentation |
| Leaving incarceration | 60 days after | Release documentation |
| Marketplace or plan error | Case by case | Documentation of the error |
| Income change making you newly eligible for cost-sharing reductions | 60 days after | Income documentation |
What does not count
- Voluntarily dropping coverage. Cancelling a plan you could have kept does not open a window.
- Losing a job, by itself. The trigger is losing the coverage, not the employment.
- Losing a client or a contract if you are self-employed. There was no coverage attached, so there is nothing to lose.
- A premium increase. However large. This surprises people every year.
- Getting sick or receiving a diagnosis. This is what an enrollment period is designed to prevent.
- Moving for medical treatment, or a short-term or seasonal move without changing residence.
The route that closed
Until 2025 there was a monthly special enrollment period for households at or below 150% of the federal poverty level. In practice it functioned as year-round enrollment for lower-income people, and it was how a great many of them got covered.
It was repealed by rulemaking in 2025. Separately, the 2025 reconciliation law barred premium tax credits for anyone enrolling through an income-based special enrollment period at all. Because that second piece sits in statute rather than in a regulation, the litigation that struck down other 2027 rules cannot bring it back. It is gone.
Verification, currently
A 2027 rule would have required documentation for at least 75% of new special enrollment period enrollments across all event types. A federal court enjoined it in July 2026, so as of August 2026 verification on the federal marketplace remains limited to loss of minimum essential coverage. The appeal is pending, so this may change. Keep your paperwork regardless.
If nothing applies to you
- Check Medicaid and CHIP. No enrollment window, and eligibility depends on current monthly income rather than an annual projection.
- Check a spouse’s employer plan. Their plan may have its own qualifying event rules that your situation triggers.
- Mark the calendar. Open enrollment for the next plan year opens November 1. See the enrollment guide.
- Ask before assuming. The rules are more particular than they look, and people talk themselves out of windows they actually qualify for.
Common questions
How long do I have after a qualifying life event?
Usually 60 days from the event. Loss of coverage is the exception worth knowing: you get 60 days before and 60 days after, so you can enroll in advance and avoid a gap entirely.
Is losing my job a qualifying event?
Losing job-based coverage is. Losing the job itself is not, on its own. If you keep coverage through COBRA, the clock starts when that coverage ends or when you exhaust COBRA, not when you left the job. Voluntarily dropping COBRA early does not trigger a new window.
What happened to the low-income special enrollment period?
It is gone permanently. The monthly special enrollment period for households at or below 150% of the federal poverty level was repealed by rulemaking in 2025, and the 2025 reconciliation law separately barred premium tax credits for anyone enrolling through an income-based special enrollment period. Because that second piece is statutory, litigation cannot restore it.
Will I have to prove my life event?
For loss of coverage, yes, on the federal marketplace. Broader pre-enrollment verification was finalised for 2027 but a federal court enjoined it in July 2026, so as of August 2026 verification remains limited to loss of minimum essential coverage. That could change if the appeal succeeds. Keep your documentation either way.
Sources
- 1.HealthCare.gov: Dates and deadlines
- 2.CMS 2025 Marketplace Integrity and Affordability final rule
- 3.CMS legal statement on the City of Columbus litigation
- 4.KFF: How the 2025 budget reconciliation law affects the ACA
Marketplace rules change through legislation, rulemaking, and litigation. Confirm anything you are about to act on, or call and ask.
Keep reading
Not sure whether you qualify?
Special enrollment rules are more particular than they look, and the window is short. Two minutes on the phone will tell you whether you have one.