You meant to sign up. Then the holidays happened, and now the deadline has passed. If you missed Open Enrollment, take a breath: you may still have more options than you think.
Here's what's still possible, and how to tell which option applies to you.
First: confirm the deadline really passed
Open Enrollment for individual health insurance usually runs from November 1 to January 15 in most states. But several state-run marketplaces stay open longer. California, New Jersey, New York, Rhode Island and Washington, D.C., for example, run to January 31. Check your state's marketplace before assuming you're too late.
If you missed your employer's Open Enrollment at work, the rules are different. See the section on job-based coverage below.
Option 1: Qualify for a Special Enrollment Period
A Special Enrollment Period (SEP) lets you sign up outside Open Enrollment after certain life events. You usually have 60 days from the event to pick a plan. Common qualifying events include:
- Losing other health coverage, such as leaving a job, aging off a parent's plan at 26, or losing Medicaid
- Moving to a new ZIP code or county with different plan options (you generally must have had coverage before the move)
- Getting married
- Having a baby, adopting or placing a child for adoption or foster care
- Becoming a U.S. citizen or gaining lawful presence
- Leaving incarceration
You may be asked for documents proving the event, so keep paperwork like a termination letter, lease or marriage certificate handy.
Note: Voluntarily dropping coverage, or losing it because you didn't pay premiums, usually doesn't qualify.
If you recently left a job, our guide to health insurance between jobs covers your options in detail.
Option 2: Apply for Medicaid or CHIP (any time)
Medicaid and the Children's Health Insurance Program (CHIP) don't have enrollment periods. If your income is low or has recently dropped, you can apply any day of the year, and coverage can sometimes be backdated.
Children often qualify for CHIP at higher income levels than adults qualify for Medicaid, so check even if you assume your family earns too much.
Option 3: Get coverage through a new job
Starting a new job with health benefits gives you a chance to enroll through that employer, usually within 30 days of becoming eligible. Employers can have a waiting period, but federal rules limit it to 90 days.
Option 4: Join a spouse's or parent's plan after a qualifying event
If you get married, have a baby or lose your own coverage, you may be able to join a spouse's job-based plan. Employer plans typically give you 30 days to request enrollment after the event. Young adults can stay on a parent's plan until age 26.
Option 5: American Indians and Alaska Natives can enroll any time
Members of federally recognized tribes and Alaska Native shareholders can enroll in or change Marketplace plans once per month, all year.
Option 6: Short-term health insurance, as a stopgap
If you don't qualify for any of the above, a short-term health plan may be available in your state. These plans can be quick and inexpensive, but they come with real limits:
- They can deny coverage for pre-existing conditions
- They often exclude prescriptions, maternity care and mental health care
- They may cap how much they'll pay
- Some states don't allow them at all
They're best treated as a temporary bridge for healthy people until the next Open Enrollment.
Option 7: Plan ahead for next year
If none of these options fit, mark your calendar for the next Open Enrollment, which begins November 1. In the meantime:
- Look for community health centers. They charge on a sliding scale based on income.
- Ask about cash prices. Many clinics and labs offer lower self-pay rates.
- Use discount programs for prescriptions to lower drug costs (these aren't insurance).
When Open Enrollment comes around, our Open Enrollment checklist will help you choose the right plan.
What if you missed Open Enrollment at work?
Employer plans have their own annual enrollment window. If you miss it, you usually can't join or change your job-based coverage until the next one, unless you have a qualifying event like marriage, a new baby or losing other coverage. In that case you typically have 30 days to request enrollment.
Talk to HR right away. Some employers will help if you can show a genuine mistake, especially if the deadline just passed.
Get help finding your options
The rules for Special Enrollment Periods can be confusing, and the right choice depends on your situation. Request a free health insurance quote, and a licensed professional can help you figure out what you qualify for, with no pressure.
Frequently asked questions
What happens if I miss Open Enrollment?
You generally can't buy a Marketplace plan until the next Open Enrollment unless you have a qualifying life event that triggers a Special Enrollment Period. Medicaid and CHIP are available any time if you qualify.
How long is a Special Enrollment Period?
Usually 60 days from the qualifying event for Marketplace plans, and usually 30 days for employer plans.
Does losing my job let me get health insurance outside Open Enrollment?
Yes. Losing job-based coverage is a qualifying event, whether you quit, were laid off or were fired.
Is there a penalty for not having health insurance?
There's no federal penalty, but California, Massachusetts, New Jersey, Rhode Island and Washington, D.C. have their own requirements and may charge a penalty at tax time.
Can I get health insurance any time of year?
Only in certain situations: with a qualifying life event, through Medicaid or CHIP, through a new job, or if you're a member of a federally recognized tribe.
This article is general information, not legal advice. Enrollment rules and deadlines vary by state and plan. Confirm details with your state marketplace, employer or a licensed professional.
