Special Enrollment Period

Making Changes to Your Plan: Special Enrollment Periods

For Individual & Family Members

When life brings change, your health coverage may need to change too. Under the Affordable Care Act (ACA) there are rules about when you can make mid-year changes to coverage. Now that the Open Enrollment Period has ended (Dec. 15), you can only make changes to your coverage if you experience a qualifying life event. Learn more below.

Qualifying Life Events

You may qualify to enroll through a Special Enrollment Period if one of the following applies to you.

Change to your household or family structure +

If there was a change to your household or family structure, you may qualify for a Special Enrollment Period.

Examples include:

Getting married
Had a baby or adopted a child
Had a child placed for foster care
Getting divorced or legally separated and lost health insurance
Death in the family and lost health insurance as a result

Change to where you live +

If you permanently moved, you may qualify for a Special Enrollment Period.

Examples of qualified moves include:

Moving to a different ZIP code or county
Moving to the U.S. from another country
Student moving to or from the place they attend school

Note: In addition to moving, you also must prove you had qualifying health coverage for one or more days during the 60 days before your move.

Losing your health insurance coverage +

If you or anyone in your household involuntarily lost their health coverage due to a policy subscriber moving to Medicare or employer-based coverage, you may qualify for a Special Enrollment Period.

Examples of involuntary loss of coverage include:

Losing employment-based health insurance
Losing individual health insurance
Losing eligibility for public insurance coverage such as Medicare, Medicaid or CHIP

Note: Voluntarily ending your health coverage or being terminated for not paying your premiums are not considered involuntary loss of coverage.

Other qualifying events +

Other complicated or less common situations may also qualify you for a Special Enrollment Period.

Examples include:

Becoming a U.S. citizen
Released from prison
Experience a Marketplace enrollment error
Changes to your income that could make you eligible to enroll in a different type of coverage, either individual or a public insurance program like Medicaid or CHIP
Determined ineligible for Medicaid or CHIP

Your state's Health Insurance Marketplace will have a complete list.

Making changes to your coverage

If you believe one of the life events above applies to you, here's what you need to know.

If you enrolled through your state's Health Insurance Marketplace (HealthCare.gov/MNsure) +

You must work with your state’s Health Insurance Marketplace to change or update your coverage. Typically, you must request changes to your coverage within 60 days of the event date.

Follow our three-step process to request changes >

If you enrolled directly through Medica (off-Marketplace) +

You must request changes to your coverage within 60 days of the event date.

Follow our three-step process to request changes >

Making Changes to Your Plan: Special Enrollment Periods

For Individual & Family Members

Qualifying Life Events

Making changes to your coverage

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