Qualifying life events.
| Life event | Notes |
|---|---|
| Losing health coverage | Job-based coverage ending, aging off a parent's plan at 26, losing Medicaid or CHIP, COBRA ending. You can apply up to 60 days before the loss. Quitting a plan or not paying premiums does not count. |
| Moving | To a new ZIP code or county with different plans. You generally must have had qualifying coverage for at least one day in the 60 days before the move. |
| Marriage | Either spouse can enroll. Coverage starts the first of the next month. |
| Birth, adoption, foster care | Coverage can be backdated to the day of the event. |
| Divorce with loss of coverage | Only if you lose coverage as a result. |
| New job offer of an ICHRA (CHOICE Arrangement) | Employees newly offered an individual coverage HRA get a window to buy individual coverage. |
| Becoming a citizen or lawfully present, leaving incarceration | Both open a window. |
| Enrolled member of a federally recognized tribe | Can enroll or change plans once a month, all year. See EnrollNative. |
What no longer counts.
From 2022 to 2025, people with income under 150% of the poverty level could enroll any month. That window was removed effective August 25, 2025, it was not restored by the 2026 court rulings, and a 2025 federal law separately bars the premium tax credit for enrollment through income-based windows. Having a low income alone no longer opens enrollment.
A change in income is also not, by itself, a way to enroll if you are uninsured. If you are already enrolled, report it; your savings can change.
When coverage starts.
For most events, coverage starts on the first day of the month after you pick a plan. If you report a coming loss of coverage before it happens, you can line the new plan up to start the day after the old one ends. Birth, adoption and foster placement can start on the date of the event.
HealthCare.gov may ask for documents proving the event, such as a letter from your old insurer showing the end date. Upload them promptly; the plan can be held until they are verified.
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Get my free optionsIf you do not have a qualifying event.
- Medicaid and CHIP: apply any time. See Texas Medicaid limits or SoonerCare limits.
- Job-based coverage: your employer's plan may have its own enrollment window.
- Wait for Open Enrollment: November 1 to January 15. See Open Enrollment 2027.
- Stopgaps: supplemental policies such as accident or hospital indemnity are not health insurance and do not replace it, but they can pay cash benefits while you wait.
Questions people ask.
Can I get health insurance outside of Open Enrollment?
Yes, with a qualifying life event, usually within 60 days of it. Medicaid and CHIP enroll all year, and enrolled tribal members can enroll monthly.
How long is a Special Enrollment Period?
Usually 60 days from the event. For a coming loss of coverage, you can also apply up to 60 days before it happens.
Is losing my job a qualifying life event?
Losing the health coverage that came with the job is. Coverage you lose because you stopped paying premiums is not.
Sources.
- HealthCare.gov, Special Enrollment Period. healthcare.gov
- 45 CFR 155.420, Special enrollment periods. ecfr.gov
- H.R. 1 (Public Law 119-21), sections 71304, 71305 and 71307. congress.gov
- HealthCare.gov, Dates and deadlines. healthcare.gov
General information for Texas and Oklahoma residents, not tax or legal advice. Rules and numbers can change; this page is reviewed on the date shown above. Your eligibility and prices are set by HealthCare.gov or the insurer when you apply.
Who wrote this.
RedHealth Advisors LLC is a licensed health insurance agency in Round Rock, Texas (Texas agency license 3449979, NPN 22110493), serving Texas and Oklahoma. Ryan Hutson is a licensed agent (NPN 21321807). Licensing details.