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Globalcare Consulting· ACA / Individual

Special enrollment · life events

ACA Special Enrollment & Life Events

Marriage, a new baby, a lost job, a move — certain life changes open a window to enroll in or switch health coverage any time of year. These are called qualifying life events, and most give you 60 days to act. Here’s what counts, how long you have, and what you’ll need to show.

The window, in one picture

Your clock starts the day of the event

For most qualifying events, you have 60 days from the date it happened to pick a plan. Miss it, and you’ll need to wait for the next open enrollment — unless something else qualifying happens first. A few events (losing Medicaid, for instance) allow up to 90 days in most states. And if you know coverage is ending — a job loss you’re already aware of, a plan that’s not renewing on the calendar year — you can often enroll up to 60 days before it happens, so there’s no gap at all.

What actually qualifies

Four categories cover almost everything. If you're not sure yours fits, ask — it usually does.

  • Losing coverage

    • Lost a job, or your employer dropped your plan
    • COBRA coverage ran out
    • Turned 26 and aged off a parent's plan
    • Lost Medicaid or CHIP eligibility
    • Employer plan became unaffordable or lost minimum value

  • Household changes

    • Got married
    • Had a baby, adopted, or placed a child in foster care
    • Divorced or legally separated and lost coverage
    • A death that causes you to lose your plan

  • Moving

    Doesn’t count: a move for medical treatment only, or a vacation stay.

    • Moved to a new ZIP code or county with different plans
    • Moved to the U.S. from another country or territory
    • Moved for school or a new job

  • Other qualifying changes

    • Income change that newly qualifies you for savings
    • Gained citizenship or lawful presence
    • Released from incarceration
    • Enrollment or plan error that wasn't your fault

A quirk worth knowing in New Jersey and New York

Pregnancy itself is a qualifying event here

Nationally, pregnancy alone usually isn’t a qualifying life event — you generally need the birth itself. New Jersey and New York are exceptions: both states let a pregnant woman enroll in coverage during the pregnancy, not just after delivery. If you’re expecting and uninsured, don’t wait for the baby to arrive to start this conversation.

What you'll need to show

Proof requirements are taken more seriously than they used to be. Have this ready before you start.

Marriage

Marriage certificate or certified copy of the license.

New baby / adoption

Birth certificate, hospital discharge papers, adoption decree, or foster placement order.

Divorce / separation

Decree or agreement showing the date coverage was lost.

Death of a plan member

Death certificate.

Lost employer coverage

Letter confirming the coverage end date; COBRA election notice if offered.

Moved

Proof of prior address and new address, plus proof of prior coverage.

Warning

2026 note

Marketplaces are verifying qualifying events more closely than in prior years — expect to be asked for documentation more often, even for events that used to go through with less scrutiny. Submit everything promptly; incomplete documentation is one of the few things that can actually cost you the window.

Frequently asked questions

Most qualifying events give you 60 days from the date of the event. Losing Medicaid or CHIP typically allows up to 90 days in most states. For events you can see coming — a known coverage end date — you may be able to enroll up to 60 days in advance, so coverage starts without a gap.

Usually the first day of the month after you enroll. A new baby or newly adopted child is the exception — coverage can be retroactive to the date of birth or adoption itself, even if you enroll later within the window.

You’ll generally need to wait for the next annual open enrollment period, unless another qualifying event happens in the meantime. This is exactly why acting quickly after a life change matters — there’s little flexibility once the window closes.

Enrolling through a special enrollment period doesn’t change your subsidy eligibility rules — you’re still assessed the same way based on income and household size as anyone enrolling during open enrollment.

Just went through a life change?

Tell us what happened — we’ll tell you if it opens a window, and help you use it before it closes.

Talk to us