What Is A Health Insurance Special Enrollment Period (SEP)?

If you need to sign up for insurance, there’s a chance you qualify for a health insurance special enrollment period (SEP). Each year from November 1st-January 15th is open enrollment for health insurance. During this time you may shop for and select a plan for the upcoming year. However, outside of this window you must follow the reasoning requirements of the marketplace to qualify for a plan. If you don’t have a qualifying reason, you won’t be able to choose a plan until the next open enrollment period.

What qualifies you for a special enrollment period?

According to the Washington Healthplanfinder, here are a few reasons you may be eligible for a special enrollment period:

• You got married
• You moved to the state or a new county
• You are losing a dependent
• You gave birth or adopted a child
• You are losing your COBRA coverage
• No longer have health insurance
• Citizenship status changed
• You got out of prison

How do you find out if you qualify for a health insurance special enrollment period?

To see if you qualify for a health insurance special enrollment period, you will need to access your marketplace account (ex: Washington Healthplanfinder or Healthcare.gov). Then, report a change with the correct reason selected. If you qualify, you will be able to shop for plan. It’s important to note that some eligibility reasons will need you to select a plan by the 15th of the month for coverage to begin the 1st of the following month.

How a health insurance broker can help you find a plan

We encourage you to reach out to a broker for help selecting a plan that fits your needs. Factors such as your budget, frequency of doctor visits and prescription use, upcoming medical procedures and facilities you use will help determine the right plans for you. One of the most overlooked factors by clients is the insurance network that your doctors accept. If you choose a plan that you doctor doesn’t accept, you will need to find a new doctor.