Enrollment
ACA Special Enrollment Periods: qualifying life events cheat sheet for agents
By the QuoteDeck team · Updated · 2 min read
The short answer
Outside Open Enrollment, a client needs a qualifying life event to enroll in a Marketplace plan. The main ones are losing other health coverage, household changes such as marriage or a new child, and moving to a new ZIP code or county. Most give 60 days from the event to enroll, and losing Medicaid or CHIP gives 90 days.
Qualifying life events at a glance
| Event | Window | Notes |
|---|---|---|
| Losing job-based coverage, including COBRA | 60 days before or after the loss | Voluntarily dropping COBRA generally does not qualify |
| Losing individual coverage | 60 days before or after the loss | For example, a plan discontinued or a move out of the service area |
| Losing Medicaid or CHIP | 90 days | Includes a child aging out of CHIP |
| Losing premium-free Medicare Part A | 60 days | Losing Part A for nonpayment, or only Part B or D, does not qualify |
| Turning 26 and coming off a parent’s plan | 60 days | Or the state’s maximum dependent age |
| Marriage | 60 days | Pick a plan by the last day of the month and coverage can start the first of the next month |
| Birth, adoption or foster placement | 60 days | Coverage can start the day of the event |
| Divorce or legal separation that ends coverage | 60 days | Divorce without losing coverage does not qualify |
| Moving to a new ZIP code or county | Check HealthCare.gov | Moves for medical treatment or vacation do not qualify |
| Offer of an individual coverage HRA or QSEHRA | 60 days before or after | Enroll through the Marketplace Call Center, not online |
Other events that can qualify
- Becoming a U.S. citizen.
- Leaving incarceration.
- Gaining membership in a federally recognized tribe or ANCSA Corporation shareholder status.
- Starting or ending AmeriCorps State and National, VISTA or NCCC service.
- Unexpected events outside the client’s control, such as natural disasters.
- A drop in household income that makes the client newly eligible for savings, in some loss-of-coverage situations.
How to handle a Special Enrollment Period client
- Confirm the event and its date, and count the window from that date.
- Collect proof of the event early. The Marketplace can ask for documents.
- Quote and present options the same day. The window is short.
- Submit the application, then follow up until the first premium is paid.
Find a client’s exact deadline with the free Special Enrollment Period calculator
QuoteDeck collects the household, income, doctors and prescriptions through a quote request form before the call, so you can quote and present Marketplace options the same day and keep follow-ups on the client record.
Frequently asked questions
How long does a client have to enroll after a qualifying life event?
Usually 60 days. Losing Medicaid or CHIP gives 90 days. For loss of coverage, clients can also enroll up to 60 days before the loss.
Does voluntarily dropping COBRA qualify for a Special Enrollment Period?
Generally no. Losing COBRA because it ran out or the employer stopped paying qualifies, but choosing to drop it generally does not.
When does coverage start after a birth or adoption?
Coverage can start the day of the event, even if the client enrolls up to 60 days later.
Sources
Checked on October 16, 2026. Rules change, so confirm with the source and your carriers.
This guide is general information for licensed insurance professionals, not legal or compliance advice. Follow CMS, state and carrier requirements that apply to you.
Quote Special Enrollment clients the same day
Collect the household before the call, then quote and present Marketplace options in one link.