Some consumers may still be eligible to enroll in Marketplace coverage for Plan Year 2022 if they qualify for a special enrollment period (SEP).

Although Open Enrollment is over, some consumers may still be eligible to enroll in Marketplace coverage for Plan Year 2022 if they qualify for a special enrollment period (SEP). SEPs provide an opportunity to individuals who experience certain qualifying events to enroll in or change their health coverage outside of the annual Open Enrollment Period. SEP qualifying events fall into six categories:

  • Loss of qualifying health coverage
  • Change in household size
  • Changes in place of permanent residence
  • Changes in eligibility for Marketplace coverage or help paying for coverage
  • Enrollment or plan error
  • Other situations

Consumers can report a life change to the Marketplace through their Marketplace application. After consumers report changes to the Marketplace, they’ll receive a new eligibility notice that explains:

  • Whether they qualify for an SEP that allows them to make changes to their coverage
  • Whether they’re eligible for a different amount of financial assistance based on their new household income, household size, or other changed information
  • Whether they may be eligible for a different kind of coverage, such as Medicaid or CHIP

In most cases, consumers have 60 days from the date of the qualifying event to enroll in coverage. If consumers are enrolling in Marketplace coverage for the first time, they may need to submit documents to prove SEP eligibility. Consumers who are members of a federally recognized Indian tribe or Alaska Native Claims Settlement Act Corporation shareholders can sign up for or change plans once per month throughout the year.

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