Special Enrollment Period 2026: How to Get Health Insurance After Open Enrollment

You missed Open Enrollment. Now what?

The 2026 Open Enrollment period ran from November 1, 2025 through January 15, 2026. It's over. But that doesn't mean you can't get health insurance right now.

If you've had a qualifying life event — lost a job, lost Medicaid, got married, had a baby, moved — you get a Special Enrollment Period (SEP) that lets you sign up for a marketplace plan. About 5 million people use SEPs each year. It's not a loophole; it's how the system is designed to work.

This guide is specifically about enrolling in 2026, because two things are different this year: the enhanced subsidies expired, and Medicaid redeterminations are still pushing people onto the marketplace. Both affect what you'll pay and which plan makes sense.

Need coverage now? Tell Nora about your situation and she'll show you available plans with prices in your area — takes about 2 minutes.

Find my plan options

The 6 most common SEP scenarios in 2026

Every SEP starts with a qualifying life event. Here are the situations we're seeing most in 2026, with specific guidance for each.

1. Lost Medicaid during redetermination

States are still working through Medicaid redeterminations that started in 2023 when the continuous enrollment requirement ended. Millions of people have been disenrolled, and it's still happening in 2026. If you got a letter saying your Medicaid coverage ended, you have a Special Enrollment Period.

• Your window: 90 days from the date you lost Medicaid (longer than the standard 60 days for most other events).
• What to know in 2026: Even though the enhanced subsidies expired, people coming off Medicaid typically have lower incomes that still qualify for significant help. If your income is below 250% FPL, a Silver plan with cost-sharing reductions is almost certainly your best option — you'll get lower deductibles, copays, and out-of-pocket maximums on top of premium help.
• Watch out for: Procedural disenrollments. If you were dropped because your state couldn't reach you (not because you're actually ineligible), you may be able to get your Medicaid reinstated instead. Contact your state Medicaid office first.

2. Lost a job

Getting laid off, fired, or having your hours cut below the threshold for employer coverage all trigger a SEP. This is the classic scenario, and the most important decision is COBRA vs. marketplace.

• Your window: 60 days from the date you lose coverage.
• COBRA vs. marketplace: COBRA lets you keep your exact same plan, but you pay the full premium (typically $600-$800/month for an individual). A marketplace plan with a subsidy could be half that or less. In 2026, even with smaller subsidies, marketplace plans usually win on cost if your income qualifies.
• The 2026 wrinkle: With the subsidy cliff back at 400% FPL, if your income from your previous job puts you above $62,600 (single), you won't get any subsidy. But if you're now unemployed or earning less, estimate your actual 2026 income — it might be well below the cliff, making a marketplace plan very affordable.
• Don't elect COBRA yet: You have 60 days to decide on COBRA, and you can elect it retroactively. Use that time to compare marketplace options first.

3. Turning 26 this year

Under the ACA, you can stay on a parent's health plan until you turn 26. After that, you're on your own. When exactly you lose coverage depends on the plan:

• Most plans drop you at the end of the month you turn 26. Some drop you on your actual birthday.
• Your window: 60 days from when you lose coverage.
• Plan ahead: Unlike other SEPs, you know this one is coming. Check with your parent's plan for the exact drop date, then start comparing marketplace plans 2-3 weeks before. If you enroll before the 15th of the month, coverage starts the 1st of the following month, helping you avoid a gap.
• 2026 subsidy reality: If you're a recent grad or early-career worker earning $30,000-$40,000, you're in the sweet spot for subsidies even with the cliff back. Young adults also get the lowest base premiums due to age rating.

4. Getting married or divorced

Both marriage and divorce are qualifying events that trigger a 60-day SEP. But in 2026, the subsidy math is more complicated because the cliff is back.

• Getting married: Your incomes combine for subsidy purposes. Two people earning $40,000 each become a household at $80,000. For a family of two, 400% FPL is about $82,700 — so you're right near the cliff. If the combined income pushes you over, you lose the subsidy entirely. Consider whether one spouse's employer plan might be cheaper.
• Getting divorced: Your income drops to just yours, which often means a larger subsidy. If you were on your spouse's employer plan, you lose that coverage and get a SEP. The marketplace is usually the best next step.

5. Having a baby

Birth and adoption both trigger a 60-day SEP with an important bonus: coverage for the child is retroactive to the date of birth or adoption.

• Your window: 60 days from the birth or adoption date.
• Adding a dependent changes your subsidy: A baby increases your household size, which raises your FPL threshold. If you were a couple near the 400% FPL cliff, adding a dependent could push you back under it and restore your subsidy eligibility.
• Don't forget Medicaid/CHIP: Many children qualify for Medicaid or CHIP even when their parents don't. Income limits for children are much higher (often 200-300% FPL or more). This has no enrollment period.

6. Moving to a new state

Moving to a new ZIP code or county with different plan options triggers a SEP. This includes moving to the U.S. from abroad.

• Your window: 60 days after your move.
• What changes: Different states have different insurance carriers, plan networks, premium rates, and possibly a different exchange entirely. About 18 states run their own marketplace instead of using HealthCare.gov.
• Requirement: You need to have had qualifying coverage for at least one of the 60 days before your move (unless you moved from outside the U.S.).
• Critical action: Don't assume your current plan works in your new location. Doctors, hospitals, and pharmacies in your network will almost certainly be different.

Do I qualify for a SEP? Check here.

2026 subsidies: smaller but still significant

The enhanced premium tax credits from the Inflation Reduction Act expired on December 31, 2025. This means two big changes for anyone enrolling through a SEP in 2026:

The 400% FPL cliff is back. If your annual income exceeds 400% of the federal poverty level — about $62,600 for a single person or $128,600 for a family of four — you get zero subsidy. Not a reduced subsidy. Zero. There's no gradual phase-out.

Premium contributions went up. Even below the cliff, you're expected to pay a higher percentage of your income toward premiums than you were in 2025. At 200% FPL, the required contribution jumped from about 2% to 6.6% of income.

But subsidies are still worth real money. A 35-year-old earning $35,000 can still get several hundred dollars per month in premium help. And cost-sharing reductions on Silver plans are unchanged — if your income is below 250% FPL, a Silver plan is almost always the best deal because you get lower deductibles, copays, and out-of-pocket maximums.

Get your income estimate right. In 2026, with the cliff back and no repayment caps for some income brackets, overestimating or underestimating your income is more costly than before. If you end up earning more than you projected and cross the 400% FPL threshold, you'll owe the entire subsidy back at tax time. Use the calculator below to see where you stand.

How to enroll through a SEP in 2026: step by step

The fastest way is to start with Nora — she'll show you available plans and prices based on your situation without needing to create an account. But here's the full manual process:

1. Go to HealthCare.gov (or your state's marketplace if your state runs its own exchange).
2. Create an account or log in. Select "Report a life change" or "Apply for a Special Enrollment Period."
3. Select your qualifying event and enter the date it happened (or will happen).
4. Complete the application with your household size, income, and other details. Be precise with income — the cliff makes accuracy more important than ever.
5. Upload or mail any required documentation (see below).
6. Browse and compare plans. Pay attention to total estimated cost, not just the monthly premium.
7. Select a plan and pay your first month's premium. Coverage isn't active until that first payment goes through.

You can also call the marketplace at 1-800-318-2596 (TTY: 1-855-889-4325) or find a local certified enrollment assister or broker at no cost.

Documents you may need

• Termination letter from your employer (with coverage end date)
• Medicaid or CHIP termination notice
• COBRA election notice
• Marriage certificate or divorce decree
• Birth certificate or adoption order
• Lease, utility bill, or other proof of new address (for moves)
• Pay stubs or tax return for income verification

When does coverage start?

The "15th of the month" rule determines your start date:

• Enroll by the 15th: coverage starts the 1st of the next month.
• Enroll after the 15th: coverage starts the 1st of the month after next.
• Birth or adoption: coverage is retroactive to the date of the event.

For example, if you enroll on March 10, coverage starts April 1. If you enroll on March 20, coverage starts May 1. Don't wait until the last day of your window — processing delays can push your start date back further.

Ready to see your options? Nora can pull up plans and subsidy estimates for your specific situation in about 2 minutes.

Show me plans

What if you don't qualify for a SEP?

If nothing on the qualifying events list applies to you, you can't enroll in a marketplace plan right now. But you still have some options, each with significant trade-offs.

Medicaid

Medicaid has no enrollment period — you can apply any time. If your state expanded Medicaid (41 states plus D.C. have), you qualify if your income is at or below 138% FPL (about $21,600 for a single person in 2026). Apply through your state Medicaid office or at HealthCare.gov, which will route you automatically.

Short-term health insurance

Short-term plans are available year-round and are cheaper than marketplace plans. But there are serious limitations:

• They can deny coverage or charge more for pre-existing conditions.
• They typically don't cover prescriptions, maternity, or mental health.
• They don't count as minimum essential coverage.
• They don't qualify for subsidies.
• Duration limits vary by state (some cap at 3 months, others allow 12).

A short-term plan can make sense as a bridge if you're healthy, need something temporary, and just want catastrophic protection. It is not a substitute for real health insurance.

Healthcare sharing ministries

These are member-funded organizations where participants share each other's medical costs. They are not insurance — they are not regulated by state insurance departments, they can deny claims for pre-existing conditions, and they are not legally obligated to pay any specific claim. Some people use them, but go in with your eyes open about the risks.

Wait for Open Enrollment 2027

The next Open Enrollment period runs from November 1 through December 15, 2026 for coverage starting January 1, 2027. Note: this is a shorter window than previous years (it used to run through January 15). Mark your calendar now and don't miss it.

If you're uninsured and waiting for OE 2027, be aware that any medical expenses in the meantime are fully out of pocket. Negotiate cash rates with providers, ask about payment plans, and look into community health centers that charge on a sliding scale.