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Learn about health insurance Special Enrollment Periods (SEPs)

Sometimes, you can still get health coverage after the Open Enrollment period ends.

Father and son eating breakfast

SEPs are times when you can sign up for a new health insurance plan outside of Open Enrollment because you’ve experienced certain changes in your life, including:

Event

Enrollment Window

Coverage Takes Effect

Having a baby, adopting a child or placing a child in foster care

Up to 60 days after the event

The day of the event or the first day of the following month after you enroll. If you enroll in an individual Off-Marketplace plan on the first through the 15th of the month, your coverage will begin the first day of the next month. If you enroll on the 16th through the end of the month, your effective date will be the first day of the second following month.

Gaining a dependent through court order, including child support

Up to 60 days after the event

The day of the court order. You have options for your effective date when you enroll Off-Marketplace. If you enroll Off-Marketplace on the first through the 15th of the month, your coverage will begin the first day of the next month. If you enroll on the 16th through the end of the month, your coverage will begin the first day of the second following month.

Getting married

Up to 60 days after your marriage (you can’t enroll until after the marriage)

The first day of the month after you enroll.

Losing other health coverage

From 60 days before to 60 days after losing your other coverage

The first day of the month after you enroll and after the loss of coverage. If you enroll in an individual Off-Marketplace plan on the first through the 15th of the month, your coverage will begin the first day of the next month. If you enroll on the 16th through the end of the month, your coverage will begin the first day of the second following month.

Moving outside your insurance plan’s service area

Up to 60 days after the event

If you enroll on the first through the 15th of the month, your coverage will begin the first day of the next month. If you enroll on the 16th through the end of the month, your coverage will begin the first day of the second following month. If you enroll in an individual Off-Marketplace plan, you can also apply 60 days in advance of your move with coverage beginning the first day of the following month.

Becoming a U.S. citizen

Up to 60 days after the event (On-Marketplace only)

If you enroll on the first through the 15th of the month, your coverage will begin the first day of the following month. If you enroll the 16th through the end of the month, your coverage will begin the first day of the second following month.

Having a change in income or household status that qualifies you for financial assistance

Up to 60 days after the event (On-Marketplace only)

If you enroll on the first through the 15th of the month, your coverage will begin the first day of the next month. If you enroll the 16th through the end of the month, your coverage will begin the first day of the second following month.

If you’re signing up for any of the following reasons, you’ll need to send us documentation to show that the event took place:

  • Losing Minimum Essential Coverage (MEC)
  • Moving
  • Having a baby
  • Getting married
  • Gaining a dependent through adoption, placement for adoption, placement in foster care, or child support or other court order

Please be sure to include acceptable verification documents with your application. In case you forget, we’ll send you a SEP verification request letter. You’ll have 15 days from the date of the letter to send in your verification documents before your application is closed.

These are some of the acceptable forms of proof for each of these life changes:

Qualifying Event

Acceptable SEP Verification Documentation

Birth/Adoption/Foster Care  

-document must be dated within the previous 60 days

  • Birth Certificate
  • Court Order

Permanent Move and Marriage require 2 types of documentation as described in Parts A & B below

Permanent Move - Part A

-document must be dated within the previous 60 days

-document required to display current address

  • * State of Tennessee Automobile Registration
  • * Utility Bill
  • * Mortgage Statement
  • * Offer of Employment at a Tennessee Employer
  • * Drivers License
    (issued within previous 60 days only required if using Permanent Move as SEP)
  • * Rental Agreement
  • * Current Employer Verification (paycheck statement)
  • IRS Tax Reporting W-2 Form
  • Current College Tuition Bill
  • Offer of Employment at a Tennessee Employer

Marriage - Part A

-document must be dated within the previous 60 days

  • Marriage Certificate

Permanent Move - Part B
* Documentation must show enrollment in medically essential coverage for at least 1 day within 60 days prior to the permanent move.


Marriage - Part B
* Documentation must show enrollment in medically essential coverage for at least 1 day by 1 spouse, 60 days before marriage.

  • Termination of Coverage Letter from Prior Health Insurance Carrier
  • COBRA Notice & Election Form from Prior Health -
    Insurance Carrier or Employer
  • COBRA Notice of Exhaustion of Benefits Letter from Employer on Company Letterhead
    (stating the reason for loss of coverage and date of termination)
  • Notice of Loss of Medicaid Coverage
  • Dated Correctional Facility Release Documentation

Loss of dependent
(Due to Divorce, Legal Separation, or Death)

-document must be dated within the previous 60 days

  • Divorce Decree
  • Death Certificate
  • Court Order

Loss of Minimum Essential Health Insurance Coverage

-document must be dated within the previous 60 days

  • Termination of Coverage Letter from Prior Health Insurance Carrier
  • COBRA Notice & Election Form from Prior Health -
    Insurance Carrier or Employer
  • COBRA Notice of Exhaustion of Benefits Letter from Employer on Company Letterhead
    (stating the reason for loss of coverage and date of termination)
  • Notice of Loss of Medicaid Coverage
  • Death Certificate
  • Court Order
  • Dated Correctional Facility Release Documentation

Gain Dependent(s)
(Due to Child Support Order or Other Court Order)

-document must be dated within the previous 60 days

  • Court Order

Effective 9/1/2017, proof of residency is required for all new enrollments applications using an SEP outside of Open Enrollment. Refer to Permanent Move Part A for list of acceptable documentation.

If you enrolled On-Marketplace, you may call the Centers for Medicare & Medicaid Services at 1-800-318-2596 to find out if you need to send in any verification documents.

Visit HealthCare.gov to find a full list of qualifying life events and learn more about SEPs.

There are a few other “complicated” situations that could qualify you for an SEP. Call us or your broker to find out more.