Open Enrollment vs. Special Enrollment
Understanding When You Can Enroll
Open Enrollment is the once-a-year opportunity to sign up for or change health insurance.
- ACA Individual Market (Covered California): Runs November 1 – January 31 each year.
- Employer Plans: Most employers set their own annual enrollment period, often in the fall.
- Medicare: Annual Election Period is October 15 – December 7, with changes effective January 1.
What Is Open Enrollment?
Special Enrollment Periods (SEP) let you sign up outside Open Enrollment if you have a qualifying life event, such as:
- Losing employer coverage
- Marriage or divorce
- Birth or adoption of a child
- Moving to a new county or state
- Turning 26 and losing parental coverage
Most SEPs last 60 days from the event.
What Is Special Enrollment?
Why Enrollment Periods Exist
Open Enrollment helps prevent people from waiting until they are sick to buy insurance, keeping premiums stable for everyone. Special Enrollment ensures people aren’t left without options after major life changes.
If you miss Open Enrollment and don’t qualify for a SEP, you generally must wait until the next year. Some alternatives:
- Medi-Cal (California’s Medicaid) is available year-round for those who qualify.
- Short-term coverage exists but is limited in California.
- For Medicare, late enrollees may have to wait until the next General Enrollment (Jan–Mar).
What If You Miss Open Enrollment?
Frequently Asked Questions
Common Enrollment Questions
I lost my job-based insurance—can I get coverage now?
Yes. Loss of employer coverage is a qualifying life event, giving you a 60-day Special Enrollment window.
My child is turning 26—can they get a plan right away?
Yes. Aging off a parent’s plan qualifies for Special Enrollment. They can apply up to 60 days before or after turning 26.
What proof do I need for a Special Enrollment?
Usually a letter from your employer, marriage certificate, birth certificate, or other documentation of the event.
Does moving qualify me for Special Enrollment?
Yes. Moving to a new service area allows you to enroll in plans available at your new address.
When does new coverage begin if I enroll during SEP?
It usually starts the first of the month after you apply. Certain events like birth or adoption can trigger coverage from the date of the event.