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Open enrollment is over: Can you still get covered?

Big changes in your life? They could make you eligible to get health insurance coverage.

By Lauren Birchfield Kennedy of the National Partnership for Women & Families.

Certain life changes might mean you’re eligible to get health insurance (including coverage of your birth control with no out-of-pocket costs!) through the Health Insurance Marketplace outside of the open enrollment periods. Read on to find out more about your options.

Could you be eligible for special enrollment in a marketplace plan?

You can only sign up for a marketplace plan during an open enrollment period, unless you experience a “qualifying life event.”

What’s a qualifying life event?

Qualifying life events trigger special enrollment periods that allow you to sign up for private health insurance in the marketplace outside of open enrollment. Qualifying life events include getting married, having a baby, moving to another state, losing job-based coverage, and other major life changes.

For example, if you change jobs and your new employer doesn’t offer health coverage, you’ll be eligible for a special enrollment period and can sign up for a health plan in the marketplace.

You experienced a qualifying life event—now what?

If you experience a qualifying life event, you can apply for insurance through Healthcare.gov or your state’s marketplace to find out if you qualify for a special enrollment period.

Could you be eligible to enroll in Medicaid?

Medicaid, the government-sponsored health insurance program for low-income individuals and families, accepts new enrollees year-round. Eligibility for Medicaid coverage depends on your income and household size. In states that have expanded their Medicaid programs, young women without children who are paid less than $15,856 per year are eligible for Medicaid. (Unfortunately, many states have chosen not to expand their Medicaid programs. See if your state is one of them.)

If you think you may be eligible for Medicaid coverage, you can learn more at healthcare.gov.

One last thing…

If you enroll in a health plan through the marketplace, be sure to stay on top of reporting changes in your income or family size to the marketplace, since those changes may affect your eligibility for Medicaid, premium tax credits, or cost-sharing subsidies. Reporting changes to the marketplace when they happen will ensure you receive the right financial help and avoid surprises at tax time!


Lauren Birchfield Kennedy is the Director of Health Policy at the National Partnership for Women & Families. Kennedy advises the National Partnership’s health policy agenda and oversees advocacy strategy for key policy priorities, including Affordable Care Act implementation and insurance market reform. She has an extensive background in women’s health policy and expertise in health programs serving lower income women, including Medicaid and the Title X family-planning program. Kennedy holds a law degree from Harvard Law School and a B.A. from UCLA. She splits time between D.C. and Massachusetts, all the while dreaming of her native California.

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