What Is a Special Enrollment Period (SEP)?

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Each year, there is an Open Enrollment Period (OEP), during which people can buy health insurance. In 2022, the OEP is November 15 through January 15. If you do not enroll during that time and experience certain life changes, you can enroll during a Special Enrollment Period.

What Is the Special Enrollment Period (SEP)?

You can sign up for a health insurance plan outside of the Open Enrollment Period during a Special Enrollment Period (SEP) if you qualify with a life event, such as:

  • Getting married
  • Getting divorced or separated
  • Having or adopting a child
  • Losing a job
  • Moving
  • Graduating from college
  • An enrollment or plan error
  • Getting offered an individual coverage HRA (ICHRA) or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) from an employer
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming a U.S. citizen
  • Leaving prison
  • Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member
  • If you lose health insurance coverage when a partner dies

Note:  Extensive traveling and moving residences for medical treatment do not count towards eligibility to enroll in coverage during SEP.

If you do not buy health insurance during Open Enrollment and experience certain life changes, you can enroll during a Special Enrollment Period.

How Long Is the Special Enrollment Period?

You will have 60 days before and after the event to buy health insurance. If you miss the Open Enrollment Period due to COVID, you will still be eligible to buy a plan.

You may be asked to submit documents based on the life event you attest makes you eligible for SEP. This does not mean that you are disqualified, but you may lose your chance if you do not submit the requested documents in a timely manner.

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Special Enrollment Period FAQs

What if I’m turned down for the special enrollment period?

If you believe you are eligible for SEP but are turned down, you may appeal the decision within 90 days of your notice that you are ineligible to buy health insurance at this time. If you miss the 90-day mark, you may ask for an extension if you have a valid reason for not appealing within the designated time.

How should I apply for health insurance during the special enrollment period?

The best way to shop for health insurance is by comparing health insurance rates and plans. You may even qualify for a reduced-cost plan depending on your income.

Key Takeaways

  • Enroll in a health insurance plan during Open Enrollment
  • You have 60 days before and after a qualifying life event to be eligible for the Special Enrollment Period.
  • If you are turned down for SEP, you have 90 days to appeal your case.

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