When to Enroll in the Marketplace

Open Enrollment

The Obamacare Open Enrollment Period, also known as the Health Insurance Marketplace Open Enrollment Period, is a specific time frame during which individuals and families can enroll in, renew, or make changes to their health insurance coverage through the Health Insurance Marketplace established by the Affordable Care Act (ACA), often referred to as Obamacare.

Open Enrollment for 2024 is 11/1/2023 through 12/15/2023 for plan effective dates of 1/1/2024. During this period anyone may enroll in or make changes to their health insurance through the Marketplace.

Special Enrollment Periods

Special Enrollment Periods (SEPs) for Obamacare, officially known as the Affordable Care Act (ACA), are specific time frames outside of the annual Open Enrollment period during which individuals and families can enroll in or make changes to their health insurance coverage. SEPs are designed to accommodate life events or circumstances that may affect an individual’s need for health insurance.

Here’s a brief description of Special Enrollment Periods for Obamacare:

  1. Qualifying Life Events: SEPs are triggered by certain qualifying life events.
  2. Limited Time frame: When a qualifying life event occurs, individuals typically have a limited time frame (usually 60 days from the date of the event) to enroll in a health insurance plan through the ACA’s Health Insurance Marketplace. This allows them to adjust their coverage to align with their changed circumstances.
  3. No Waiting Periods: During a Special Enrollment Period, individuals do not have to wait until the next annual Open Enrollment period to obtain coverage. This can be crucial for those facing sudden changes in their health insurance needs.
  4. Coverage Effective Dates: Coverage obtained through a SEP typically begins on the first day of the month following the application.

Special Enrollment Triggers.

  • Low Income – 100%-150% of Poverty level – Anytime
  • Involuntary loss of coverage – 60 days
  • Individual plan renewing outside of the regular open enrollment – 60 days
  • Becoming a dependent or gaining a dependent. – 60 days
  • Marriage – 60 days, with current coverage
  • Divorce – 60 days, with current coverage
  • Becoming a United States citizen or lawfully present resident – 60 days
  • A permanent move – 60 days, with current coverage
  • An error or problem with enrollment – determined through appeal process
  • Employer-sponsored plan becomes unaffordable or stops providing minimum value – 60 days
  • An income increase that moves you out of the coverage gap – 60 days
  • Gaining access to a QSEHRA or Individual Coverage HRA – 60 days
  • An income or circumstance change that makes you newly eligible (or ineligible) for subsidies or CSR – 60 days, with current coverage, determined through appeal process