Can You Get Health Insurance After Open Enrollment Ends?

Missing the annual health insurance open enrollment period can feel like a major setback, leaving you exposed to medical bills and uncertainty. The good news is that the answer to “can you get health insurance after open enrollment” is often yes, but it depends on your specific circumstances. A Special Enrollment Period (SEP) is the key mechanism that allows individuals and families to sign up for coverage outside the standard window, but only if they experience a qualifying life event. Understanding these rules is crucial to securing the protection you need without waiting another full year.

Understanding Special Enrollment Periods (SEPs)

A Special Enrollment Period is a time outside the annual Open Enrollment window when you can sign up for a health insurance plan through the Affordable Care Act (ACA) Marketplace or, in some cases, directly through an insurer. These periods are not random; they are triggered by specific, significant changes in your life that affect your health coverage needs. The federal government, as well as state-based Marketplaces, strictly define what constitutes a qualifying life event. It is not enough to simply want a new plan or find a better price. You must provide documentation proving the event occurred, and you typically have a limited window, usually 60 days from the date of the event, to select a new plan. Coverage usually begins the first day of the month following your plan selection.

Common Qualifying Life Events

Qualifying life events generally fall into a few key categories. The first and most common is a change in household. This includes getting married or entering a domestic partnership, having a baby, adopting a child, or placing a child for foster care. It also includes the death of a family member who was the primary policyholder, which would necessitate a new plan for remaining dependents. A change in residence is another major category, but with important caveats. You must move to a new ZIP code or county, and you must have had qualifying health coverage for at least one day in the 60 days before the move. This rule exists to prevent people from moving solely to get insurance. Exceptions include moving from a foreign country or U.S. territory, or moving to or from where you attend school. For a deeper look at how life changes affect your options, our resource on adding a spouse to health insurance covers the timing and rules in detail.

Other Pathways to Coverage Outside Open Enrollment

If you do not qualify for a Special Enrollment Period, all is not lost. Several alternative pathways exist that operate on different timelines than the ACA Marketplace. Exploring these options requires careful consideration of benefits, costs, and eligibility.

Medicaid and the Children’s Health Insurance Program (CHIP) accept applications year-round. Eligibility is based on income and household size, and if you qualify, you can enroll at any time. It is always worth checking your eligibility, especially if your income has recently decreased. Short-term health insurance plans are another option, though they come with significant limitations. These plans are not ACA-compliant, meaning they can deny coverage for pre-existing conditions, impose annual or lifetime coverage caps, and exclude essential health benefits like prescription drugs or maternity care. They are designed as temporary, stop-gap coverage for a defined period, such as a few months, and are not a substitute for comprehensive insurance. For individuals 65 and older or those with certain disabilities, Medicare has its own initial enrollment periods and special election periods, which are separate from the ACA calendar. If you are approaching this stage, our article on choosing the best health insurance for seniors in 2026 provides critical guidance.

Finally, employer-sponsored insurance is a major source of coverage. If you get a new job that offers health benefits, you can typically enroll immediately or during the company’s next open enrollment. Losing other health coverage is itself a qualifying event for a Marketplace SEP, but it is important to understand what “losing” means. It generally includes:

• Losing job-based coverage (including if you quit, are laid off, or have your hours reduced).
• Losing individual plan coverage because you are no longer in the plan’s service area.
• Losing eligibility for Medicaid or CHIP.
• Losing coverage through a family member (due to divorce, death, or the policyholder losing their job).

However, voluntarily dropping your coverage or having it terminated for not paying premiums does not count as a qualifying loss.

What Does Not Qualify for a Special Enrollment Period

It is equally important to know what circumstances will not grant you access to a Special Enrollment Period. Insurance companies and the Marketplace are strict about these guidelines to maintain the integrity of the enrollment system. Simply forgetting to enroll during Open Enrollment is not a valid reason. Similarly, realizing your current plan is too expensive or discovering a better plan after the deadline does not trigger an SEP. A change in your financial situation, like a decrease in income, does not by itself qualify you for an SEP, though it may make you newly eligible for Medicaid, which you can apply for anytime. Merely wanting to change plans because you are dissatisfied with your current network of doctors or the level of customer service is also not a qualifying event. For those considering a plan change during allowed times, our guide on when you can change health insurance plans outlines all your options.

Steps to Take if You Need Coverage Now

If you find yourself without coverage and need to act, follow a systematic approach. First, determine if you have experienced a qualifying life event in the last 60 days. Gather all necessary documentation, such as a marriage certificate, birth certificate, proof of a new address, or a letter from your former employer stating your coverage ended. Next, visit HealthCare.gov or your state’s Marketplace website to apply. The application process will ask you questions to verify if you qualify for an SEP. Be prepared to upload your documents. If you do not qualify for an SEP, immediately investigate alternative options. Apply for Medicaid/CHIP through your state agency, research short-term plans with a clear understanding of their limitations, or look into catastrophic health plans if you are under 30 or qualify for a hardship exemption. If you are starting a new job, consult with the HR department about their enrollment timeline. Taking these steps methodically can help you bridge the gap in coverage. For state-specific insights, you can reference resources like our page on finding the best health insurance in Texas for 2026 to understand local market dynamics.

Frequently Asked Questions

How long do I have to enroll after a qualifying event?
In most cases, you have 60 days from the date of the qualifying life event to select a new health insurance plan through the Marketplace. If you miss this window, you generally must wait until the next Open Enrollment Period, unless you experience another qualifying event.

Can I get an SEP if I lose my job-based insurance?
Yes, losing job-based health insurance is a qualifying life event. This includes voluntary and involuntary job loss, as well as a reduction in hours that makes you ineligible for your employer’s plan. You will have 60 days from the date your coverage ends to enroll in a Marketplace plan.

Does getting married qualify me for an SEP?
Yes, getting married is a qualifying life event. Both you and your new spouse can enroll in or change plans on the Marketplace. You have 60 days from your wedding date to enroll, and coverage can be backdated to the date of the marriage in some cases.

What if I am pregnant? Does that trigger an SEP?
Pregnancy itself does not trigger a Special Enrollment Period. However, the birth of the child, adoption, or placement for foster care does. At that point, you can enroll in a new plan or add the child to your existing plan.

Can I use an SEP to switch plans if I am already insured?
Yes, if you experience a qualifying life event, you can use the SEP to switch from your current Marketplace plan to a new one, or even to switch from an employer plan to a Marketplace plan. You are not locked into your old choice.

Securing health insurance after the open enrollment deadline is entirely possible with the right knowledge and prompt action. The system is designed to accommodate major life changes, ensuring that you are not left without vital coverage during times of transition. By understanding the rules around Special Enrollment Periods, knowing what qualifies and what does not, and exploring all available pathways, you can confidently navigate the process. The most critical step is to act quickly once a qualifying event occurs, as the 60-day window is strictly enforced. Do not assume you have to wait; assess your situation, gather your documents, and explore your options to protect your health and financial well-being.