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Missed Open Enrollment? You Might Still Qualify for Coverage

Open Enrollment is closed, but the marketplace isn't. A qualifying life event opens a 60-day window to enroll - here's the full list, the documents you'll need, and what to do if nothing applies.

Key takeaway

If you missed Open Enrollment, a qualifying life event - losing other coverage, moving, marriage, divorce, a new baby, and several others - opens a 60-day Special Enrollment Period to get an ACA plan. One big change: the year-round window for incomes under 150% FPL ended in August 2025, so low income alone no longer qualifies.

How Special Enrollment Periods work

The ACA marketplace limits enrollment to specific windows so people can't wait until they're sick to buy coverage. Open Enrollment for 2027 plans runs November 1, 2026 through January 15, 2027. Outside of that, you need a qualifying life event, which triggers a Special Enrollment Period (SEP).

The standard SEP gives you 60 days from the date of the event to pick a plan, per healthcare.gov. Miss the 60 days and the window closes - so if something on the list below happened to you recently, the clock is already running. You can check your eligibility and see real plan prices on HealthSherpa in about two minutes, including any subsidy you qualify for.

The full list of qualifying life events

Some events are easy to miss. A Broward client of ours assumed leaving a job "didn't count" because she quit voluntarily - it does. Voluntary or not, losing employer coverage opens the 60-day window.

The low-income year-round window is gone - here's what replaced it

From 2022 through mid-2025, households earning under 150% of the Federal Poverty Level could enroll any month of the year, no life event required. Many South Floridians used it - and many still believe it exists.

It doesn't. CMS eliminated the low-income year-round SEP effective August 25, 2025. In 2026, your income - even well under $23,475 for an individual (150% FPL) - does not by itself open an enrollment window. You need a standard qualifying event from the list above, or you wait for Open Enrollment on November 1.

"Every week someone calls me saying a friend told them low-income enrollment is open all year. That ended in August 2025 - and the worst time to find out is after the 60-day window from a real qualifying event has already passed. When in doubt, call and ask. It costs nothing." — Victor Oliveira, Licensed Health Insurance Broker, Fort Lauderdale

Documentation: what the marketplace will ask for

SEP enrollments are usually verified, so have proof ready. Typical documents by event:

Qualifying eventAcceptable proof (examples)
Loss of coverageCoverage termination letter, COBRA notice, or letter from the employer or insurer with the end date
Permanent moveNew lease or deed, utility bill, or updated driver's license, plus proof of prior address
MarriageMarriage certificate
DivorceDivorce decree showing loss of coverage
Birth or adoptionBirth certificate, hospital record, or adoption/placement paperwork

You can typically submit your application first and upload documents within about 30 days afterward - so don't let a missing paper push you past your 60-day deadline. Apply first, document second.

No qualifying event? Here are your options

If nothing on the list applies, you have two realistic paths:

1. Bridge the gap with short-term medical. A short-term medical plan can cover you against unexpected illness or injury until Open Enrollment. Be clear-eyed about what it is: short-term plans are not ACA plans, can decline or exclude pre-existing conditions, and don't qualify for subsidies. As a bridge - not a substitute - they're a reasonable tool.

2. Mark November 1 on your calendar. Open Enrollment for 2027 coverage starts November 1, 2026. Subsidies are still substantial: households between 100% and 400% FPL qualify for premium tax credits, and $0/month bronze plans remain available for many lower-income households. Self-employed? The marketplace works for you too.

Either way, a 10-minute call sorts out which path fits - and whether an event you didn't think counted actually opens a window. Broker help is free; carriers pay the commission and your plan price never changes. Reach Victor at (954) 641-2147 or victor@affordableaccesshealth.com.

Think you might qualify? Check before the 60 days run out

See if your situation opens a Special Enrollment Period and compare real 2026 prices - or ask Victor directly. Both are free.

Frequently asked questions

How long do I have to enroll after losing job coverage?

60 days. Losing employer coverage is a qualifying life event, and your Special Enrollment Period runs 60 days from the date your old coverage ends. In many cases you can also apply up to 60 days before the loss so new coverage starts without a gap.

Can I enroll year-round if my income is low?

No - not anymore. The year-round Special Enrollment Period for households under 150% of the Federal Poverty Level was eliminated by CMS effective August 25, 2025. Low income alone no longer opens an enrollment window; you now need a standard qualifying life event or must wait for Open Enrollment.

What documents prove a qualifying life event?

It depends on the event: a coverage termination letter or COBRA notice for loss of coverage, a lease, utility bill, or driver's license update for a move, a marriage certificate, a divorce decree, or a birth certificate or adoption record. The marketplace typically gives you about 30 days to upload documents after you submit your application.

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