Special Enrollment Period qualifier

Most run 60 days from the qualifying event. A loss of coverage usually also lets you apply in the 60 days before it happens, which is better because it prevents a gap.

Miss the window and the next opportunity is normally Open Enrollment.

Voluntarily dropping coverage you could have kept, and losing coverage for non-payment of premiums. Neither opens a Special Enrollment Period.

This catches people out, because both feel like a loss of coverage.

Usually yes. The Marketplace commonly asks for documentation — a termination letter, a lease or a marriage certificate, depending on the event.

Gather it early; the request often arrives with its own deadline attached.

No. It is a guide to the common qualifying events. Only the Marketplace can determine eligibility.

This is not a complete list of Special Enrollment Periods. Visit HealthCare.gov for the full list.

If the answer here is borderline, that is exactly the case worth talking through rather than guessing.

No. It is an estimate computed from published plan-year figures and the details you type in. It is not an offer of coverage or a determination of eligibility.

Your final premium and eligibility are confirmed at enrollment on HealthCare.gov or with the carrier.

From the HHS poverty guidelines (2025) and the Marketplace affordability schedule for plan year 2026. They are plan-year stamped and reviewed each January, when the federal government publishes the new ones.

If a figure here does not match what you see elsewhere, check which plan year the other source is quoting first.

Nothing. Carriers pay a commission when a plan is issued, and that commission is already built into the plan price whether you use an agent or not.

Buying the same plan on your own does not make it cheaper — it just means nobody checked your doctors and prescriptions first, and nobody picks up the phone in March when something goes wrong.

No, and no agency does. We are independent, which means we compare across the carriers listed on this site rather than representing a single one — but that is not the same as offering every plan on the market.

We do not offer every plan available in your area. Currently we represent 8 organizations which offer 72 products in your area. Please contact Medicare.gov, 1-800-MEDICARE to get information on all of your options.