Special Enrollment Periods
Plan year 2026, last refreshed 2026-04-19T08:08:55.462Z.
ACA Open Enrollment runs roughly Nov 1 → Jan 15 in federal-marketplace states. Outside that window you can still enroll if you qualify for a Special Enrollment Period (SEP) — a triggered window after a qualifying life event. Most SEPs last 60 days from the event. Below: every SEP authorized under 45 CFR §155.420, what triggers it, and what documentation the marketplace asks for.
Loss of qualifying health coverage
What triggers it: You lose eligibility for minimum essential coverage. Includes job-based coverage ending (you or a household member quits, gets laid off, has hours cut, or ages out of a parent's plan), Medicaid/CHIP loss, COBRA running out, or a divorce-related coverage loss.
Window: 60 days before AND 60 days after the loss date.
Documentation: Letter from the prior insurer, employer benefits letter, COBRA exhaustion notice, Medicaid renewal denial, or similar dated document. The marketplace pre-screens the claim; documents are typically submitted via a follow-up upload.
Coverage starts: Generally the first of the month following plan selection. If you select before the loss date, coverage can start the day after the prior coverage ends to avoid a gap.
Authority: 45 CFR §155.420(d)(1)
Marriage
What triggers it: You got married. At least one spouse must have had minimum essential coverage for 1+ days in the 60 days before the marriage.
Window: 60 days after the marriage date.
Documentation: Marriage certificate or marriage license.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(2)(i)
Birth, adoption, or foster placement
What triggers it: A child was born, adopted, placed for adoption, or placed in foster care with you.
Window: 60 days after the event.
Documentation: Birth certificate, adoption decree, foster care placement letter, or hospital discharge summary.
Coverage starts: Retroactive to the date of the event — the new dependent is covered from the birth/placement date.
Authority: 45 CFR §155.420(d)(2)(i)
Permanent move
What triggers it: You moved to a new ZIP code, county, or state and the move changes the plans available to you. You must have had minimum essential coverage for at least 1 day in the 60 days before the move (this prevents the SEP from being abused as a year-round enrollment back door).
Window: 60 days after the move.
Documentation: Lease, mortgage, utility bill, USPS change-of-address confirmation, or similar dated document with the new address.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(7)
Becoming a US citizen, national, or lawfully present
What triggers it: You gained citizenship, national status, or lawfully present immigration status.
Window: 60 days after the status change.
Documentation: Naturalization certificate, USCIS document, or similar status-confirmation document.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(3)
Income change crossing the APTC threshold (current enrollees)
What triggers it: You're currently enrolled in a marketplace plan and your projected annual income changes such that you become newly eligible (or newly ineligible) for APTC or CSR.
Window: 60 days after the income change.
Documentation: Pay stub, tax return, self-attestation supported by employer documents.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(6)(i-ii)
Released from incarceration
What triggers it: You were released from incarceration (federal/state/local). Pre-release the marketplace classifies you as ineligible to enroll regardless of income.
Window: 60 days after release.
Documentation: Release paperwork or parole/probation documentation.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(9)
Marketplace error or exceptional circumstance
What triggers it: A marketplace technical error, casework error, or "exceptional circumstance" (natural disaster, serious illness during OEP, etc.) prevented you from enrolling during OEP.
Window: Marketplace-defined; case-by-case. Often 60 days after the resolution of the issue.
Documentation: Marketplace casework reference number; for exceptional circumstances, supporting documentation (FEMA disaster declaration, hospitalization records, etc.).
Coverage starts: Determined by the marketplace based on the circumstance.
Authority: 45 CFR §155.420(d)(4)–(5), (d)(11)
Income at or below 150% FPL (year-round SEP)
What triggers it: Your projected annual household income is at or below 150% of the Federal Poverty Level. This year-round SEP exists in FFM states (and in the SBM states that have adopted it) and lets low-income households enroll any month of the year without other qualifying events.
Window: Year-round; effective month of plan selection.
Documentation: Income attestation; reconciled at tax filing.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(16)
Native American / Alaska Native (year-round SEP)
What triggers it: Members of federally recognized tribes and Alaska Native Claims Settlement Act corporation shareholders can enroll or change plans monthly throughout the year.
Window: Year-round.
Documentation: Tribal membership card, BIA-issued document, or ANCSA shareholder letter.
Coverage starts: First of the month following plan selection.
Authority: 45 CFR §155.420(d)(8)
Don't have a qualifying event?
If none of the above applies, the next chance to enroll is the regular Open Enrollment Period — Nov 1, 2026 through Jan 15, 2027 for federal-marketplace states. Drop your email and we'll send you a one-line reminder on the day OEP opens, with the cheapest plan in your county.
What to do if you qualify
- Run a price check on the home page to see what plans are available in your county and what you'll pay after subsidies.
- Click the Enroll button on the cheapest plan — you'll be routed to HealthCare.gov or your state exchange where you complete the SEP attestation and upload documentation.
- Most SEPs require submitting documentation within 30 days of plan selection. Have your trigger document (loss-of-coverage letter, lease, marriage certificate, etc.) ready before you start.
More
- Subsidy math behind the prices on this site: methodology
- Plain-English definitions of ACA terms: glossary
- Authoritative source for the federal SEP rules: 45 CFR § 155.420