Special Enrollment Periods
Certain life events let you enroll in a Marketplace plan outside Open Enrollment, usually within 60 days of the event. Common ones include:
- Losing job-based or other health coverage
- Getting married or having a baby
- Moving to a new area
- Turning 26 and coming off a parent's plan
Private plans: apply any time
Private plans don't have an enrollment window. You can apply year-round, and approval depends on underwriting. The ones I work with most are limited benefit plans that pay set amounts for covered services, and coverage starts at least 7 days after enrollment.
If you don't qualify for a Special Enrollment Period
Then a private plan may be your main option until the next Open Enrollment. I'll check whether you qualify for a Special Enrollment Period first, then show you what a private plan would cost for your household.
Who it tends to fit
A private plan may fit
- Healthy people who missed Open Enrollment
- No qualifying life event
- Need coverage before next year
A Marketplace plan is often better
- Anyone who qualifies for a Special Enrollment Period with a subsidy
- Ongoing health conditions
- A planned pregnancy
Good to know: The private plans I offer are limited benefit policies (fixed indemnity). They pay set amounts for covered services, you're responsible for any costs above those amounts, and there's no out-of-pocket maximum. They aren't major medical insurance and aren't a substitute for ACA coverage. Pre-existing condition limitation: a condition you were diagnosed with, treated for or took medication for in the 12 months before your coverage starts isn't covered during your first 12 months.
Questions people ask
Can I get health insurance outside of Open Enrollment?
Yes. You may qualify for a Special Enrollment Period after a life event like losing coverage, getting married or moving. Private plans can be applied for any time of year.
What counts as a qualifying life event?
Common ones are losing other health coverage, getting married, having or adopting a child, moving, and turning 26. There are others, and I'll help you check.
What if I just need coverage until next year?
A private plan may work as coverage until the next Open Enrollment, as long as you understand how it pays and what it doesn't cover. I'll walk you through it.