Special enrollment
Certain events open a window to enroll or change plans outside the usual season. Most people who could use one do not know it exists, and the windows are short enough that finding out late is the same as not finding out.
Events that open a window
Not an exhaustive list, and some events have conditions attached. Ask rather than assume you do not qualify.
The rule to remember
For most qualifying events you have sixty days to enroll. The count begins on the day the thing happened — the last day of your old coverage, the date of the move, the date of the birth — not the day you got round to thinking about it.
Some events also allow the sixty days beforehand. If you know your job coverage ends at the end of next month, you can often act now and have the new plan start the day the old one stops, with no gap at all. This is much the better way to do it.
Once the window closes it closes, and the next chance is Open Enrollment. We would rather field a call that turns out to be unnecessary than take one three days too late.
Check your dates with usThe common four
Nearly every special enrollment we handle is one of these. Each usually needs a document, and having it ready is the difference between a smooth application and a stalled one.
The list of qualifying events is longer than the common four, and several have conditions that are easy to read past. People talk themselves out of a window they were entitled to more often than they try for one they were not.
The decision nobody explains
Keeps exactly the plan you had — same network, same doctors, same deductible progress. That last point matters if you are mid-treatment or have already paid down a deductible this year.
What changes is the bill. Your employer was paying a share of it; now you pay the whole thing, and people are routinely shocked by the first invoice.
Continuity, at full price
Different plan, possibly a different network — and, crucially, eligible for the premium tax credit, which COBRA is not. For a household whose income has just dropped, that is often decisive.
The catch is timing. Turning down COBRA and then changing your mind is not always possible, so the comparison is worth doing before you decide rather than after.
Usually cheaper, check the network
Everything we do, you can do without us. HealthCare.gov shows every plan available where you live — including the ones no agency represents — and lets you apply directly. The Marketplace Call Center is open 24 hours, every day, on 1-800-318-2596 (TTY 1-855-889-4325).
There is also free local help from Navigators and certified application counselors, who are trained, unbiased, and not paid by insurance companies. We say all of this out loud because an agency that hides it is telling you something about itself.
Tell us what happened and when. We will tell you in a few minutes whether you have a window and how long is left on it.