What is a Special Enrollment Period?

The annual Open Enrollment Period (OEP) runs from Nov. 1 through Jan. 15. During OEP, people can shop and enroll in a Marketplace plan and have coverage start on Jan. 1 or Feb. 1.

A Special Enrollment Period (SEP) is any time during or outside OEP for people who've gone through certain life events.

How long is a Special Enrollment Period?

If you have a qualifying life event (QLE), you can enroll for Individual and family health coverage during your SEP. Depending on the qualifying life event, you will have up to 60 days before or 60 days after to enroll in a plan during your SEP.

What you need to know

There are many rules around a Special Enrollment Period, but here are some important things to keep in mind:

  • Voluntarily canceling other health coverage or being terminated for not paying your premium is not considered a loss of coverage
  • Your coverage will start when you pick a plan, but you can't use your coverage until you confirm you qualify and you pay your first premium payment

What is a qualifying life event?

A qualifying life event (QLE) is a change in your life situation that makes you eligible for a Special Enrollment Period (SEP). These events allow you to enroll in Individual health coverage outside the annual Open Enrollment Period (OEP).

This list includes situations that most people will use to qualify and the documentation required.

  • Loss of qualifying health coverage: A letter from your employer
  • COBRA coverage ending: Notice from your COBRA administrator
  • Marriage: Marriage certificate
  • Birth of a child: Birth certificate
  • Adoption: Adoption papers or placement orders
  • Foster care placement: Proof of placement
  • Guardianship: Court order naming the legal guardian
  • Moved to a different coverage area: Proof of new address (new driver's license or rental/mortgage agreement)
  • Gained U.S. citizenship or qualified immigration status: Copy of citizenship/immigration papers
  • Aging off a parent's plan: Proof of date of birth, copy of driver's license or passport
  • Losing eligibility for Medicaid or CHIP: Copy of letter from Medicaid or CHIP
  • Death of policy holder: Copy of death certificate

The SEP enrollment process

  1. See plans & prices
  2. We ask a few questions to get started. These help us show you the right plans and prices in your area.
  3. If you check the box to see if you qualify for a federal subsidy, we'll check if you're eligible for a premium tax credit and cost-sharing reductions.
  4. You'll see MyPriority plans available in your area, along with benefits and prices.
  5. When you're ready to enroll, click on the Enroll now button. You'll be guided through the process.

You can also call 833.979.3109 to talk to an enrollment specialist. They're ready to help you enroll in the best plan for you and your family.

If you don't qualify for a Special Enrollment Period

If you don't have a QLE, you can enroll in an Individual & family health plan during OEP. See our short-term plans, which may help out until OEP starts.

If you were denied a SEP and disagree with the decision, you can appeal it within 90 days. Details can be found on healthcare.gov.

Remember this important step after you enroll

After you complete your special enrollment, your work isn't quite done.

  • You'll get a notice after you submit the application that tells you what documents you need to submit for your event and where to send them.
  • You'll have 30 days to submit documentation of your qualifying life event.
  • You can't use your coverage until you confirm you qualify and you pay your first premium payment.
  • Your eligibility notice may say you don't have to submit documents.
mom with two daughters looking at computer

How to choose a health plan

As you look for Individual health plans on the Marketplace, you'll find many different options.

It's wise to pick a health plan that fits your budget but don't rely only on your monthly premium to decide how much you'll pay every month.

Pay attention to the plan details, networks, deductibles, copays and if the plan includes extra benefits. Select a reliable and affordable plan that will support you when it matters most.

You can learn what these health plan terms mean in our Learning center.

Don't overlook additional savings

  • Check the box to see if you qualify for additional savings, even if you don't think you'll qualify. Subsidies are more widely available thanks to the American Rescue Plan and Inflation Reduction Act.
  • When you get a quote, you'll find out if your income qualifies you for extra savings known as "cost-sharing reductions." If it does, you can save a second way by paying less out-of-pocket each time you get medical services.
  • You'll only see cost-sharing reductions on Silver plans so you must shop for and purchase a Silver plan to see and qualify for cost-sharing reductions. They're worth taking a look at.
  • Note that household size and income may affect any premium tax credits (subsidies) or cost-sharing reductions.

Learn more about how you can save on health coverage.

What you can expect from a MyPriority plan

Keep in mind, a deductible is the amount you pay before the health plan starts to pay for certain services.
  • Preventive care is covered in full, before deductible: This includes physical exams, well-child visits, vaccines, screenings for breast, cervical and colon cancer and more.
  • Low prescription copays: Prescriptions and medications are covered under our plans so you can save on out-of-pocket costs.
  • 24/7 virtual urgent care1: A great option for treating minor illnesses and injuries like ear infections, fevers, coughs, minor burns or bites.
  • Chronic condition coverage is covered, before deductible: Our plans include supplies and prescriptions at zero or low cost to help manage chronic conditions, like diabetes, heart disease and asthma.
  • On-demand mental health support: You'll have free access to myStrength, an online mental health and wellness tool.
  • Maternity care is covered in full, before deductible: Get the prenatal and postnatal care you need for your special delivery.
mom and dad with two young kids in front yard of home
  • One of the largest individual networks of primary care doctors in Lower Michigan and in metro Detroit
  • Member discounts, perks and rewards with zero-added cost
  • Narrow Network plan options to save you even more
  • Our four-star rating on the Health Insurance Marketplace2 shows that we give you more for your money and do more to improve your health
  • Local, award-winning customer service that makes your needs a priority
  • A Michigan-based company committed to investing in communities to improve health, instill humanity and inspire hope

Qualify for a Special Enrollment Period?

On the next page, we'll ask a few questions and see if you qualify for additional savings to make a MyPriority health plan even more affordable.