How to Get Health Insurance After Open Enrollment

Key Takeaways

Special Enrollment Periods let you enroll in Marketplace plans after qualifying life events like losing job coverage or having a baby.

Medicaid and CHIP provide year-round enrollment for eligible low-income families.

Compare total costs including premiums, deductibles and out-of-pocket maximums when choosing health insurance after open enrollment.

What Is Open Enrollment?

Open enrollment is your annual chance to sign up for health insurance or switch plans. For marketplace coverage, this window runs from November 1 to January 15. If you want coverage starting January 1, make sure to enroll by December 15, but if you enroll after that, your coverage begins February 1.

Your employer's enrollment period differs. Most companies schedule it in the fall for the following year's coverage. You can update your benefits, add family members or pick different plan options.

But if you miss this open enrollment window, unfortunately you're stuck waiting another year, unless you have a major life change, also called a qualifying life event which lets you enroll outside of open enrollment.

Ways to Get Health Insurance After Open Enrollment

If you could not get health insurance during open enrollment, it doesn't mean you're out of options. You can still get health coverage through Special Enrollment Periods triggered by life changes, year-round programs like Medicaid and CHIP, or employer-sponsored plans. Your path to coverage depends on your circumstances and whether you qualify for specific programs. Let’s walk you through your options for getting covered after January 15, 2026.

1
Health Insurance Marketplace if You Qualify for Special Enrollment Period
Missing open enrollment can feel stressful, but you're not out of luck. Special Enrollment Periods give you another chance. You can enroll in Marketplace plans after certain life events, with most giving you 60 days to sign up. Common triggers include getting married, having a baby, losing your existing coverage or experiencing income changes that make you eligible for savings.

Just so you know, a couple of things won't qualify you: dropping coverage voluntarily (unless your income also decreased) or moving just for vacation or medical treatment. But relocating to a different ZIP code with new plan options (including moves from foreign countries) gets you in.

You'll need documentation proving your qualifying event. After picking a plan, you've got 30 days to submit the required documents. Your coverage start date depends on when you select your plan. Not sure whether your situation qualifies? Contact the Marketplace Call Center at 1-800-318-2596.
2
Medicaid or CHIP
Worried about affording coverage? Medicaid provides free or low-cost health insurance with year-round enrollment for eligible low-income adults, families, children, pregnant women, seniors and people with disabilities. If you qualify, coverage starts immediately.

You might qualify if:
- In expansion states, your household income falls below 138% of the federal poverty level (think of it as the government's poverty line).
- You're a low-income family, child, pregnant woman, senior or person with a disability, though income limits vary by state.
- Your children earn too much for Medicaid but can't afford private insurance (that's what CHIP covers), with some states also covering pregnant women.
- You qualify for Marketplace savings, which often means your children qualify for either Medicaid or CHIP.
Here's a bonus: Medicaid may cover medical costs from the previous three months, even if you weren't enrolled when you received care. This backdated coverage depends on your family's income at the time. You'll need to verify your income when applying, and some states check your assets too.
3
Employer-Sponsored Coverage
Starting a new job brings health care options outside typical enrollment periods. Most employers offer coverage within 30 to 90 days of your start date, though specific enrollment windows vary by company.

Employer plans cover you and eligible dependents. Your company typically pays part of your premium, making this more affordable than individual Marketplace plans. You'll choose your plan during your initial enrollment period. Missing this window means waiting until your employer's next open enrollment, unless you experience a qualifying life event.

Employers often offer multiple plan tiers with different costs and coverage levels. Review each option's premiums, deductibles, copays and provider networks before enrolling. Contact your HR department and ask about Health Savings Account eligibility if you're considering a high-deductible plan.
4
COBRA Coverage
COBRA lets you continue your former employer's health plan after losing job-based coverage, maintaining identical benefits, including the same deductibles, copays and provider networks. You'll pay the full premium (both your previous contribution and your employer's portion) plus up to a 2% processing fee.

You've got 60 days after losing coverage to sign up for COBRA. Your coverage kicks in retroactively to your termination date once you enroll and pay your first premium, so you won't have any gaps in coverage. COBRA typically lasts 18 months, though some situations extend coverage to 36 months.
5
Short-Term Health Plans
Short-term limited duration insurance provides temporary coverage at lower monthly costs than Marketplace plans. Coverage periods vary by state (anywhere from three months to 36 months), with some states prohibiting these plans entirely.

What you need to know about limitations:
- These plans exclude pre-existing conditions and preventive care
- Short-term plans don't meet Affordable Care Act requirements
- Plans can deny claims for any health condition you had before enrolling, even if you didn't know about it
- You'll pay all costs for pre-existing conditions, preventive care and many essential health benefits
Check your state's specific requirements before enrolling, as availability and regulations vary significantly.

What You Need to Consider When Getting Health Insurance

Getting health insurance after open enrollment means juggling a bunch of moving pieces. What you can afford, what you actually need and whether you even qualify all play into which plans make sense for your situation. The goal is finding coverage that won't leave you exposed financially without eating up your entire paycheck.

Your Total Cost

Your health insurance bill has two parts: the monthly premium you pay, whether you see a doctor or not, and what you shell out when you actually need care. The average premium after tax credits is $50 per month for the lowest cost plan in 2026 for eligible enrollees. That's $13 more than last year, according to the Centers for Medicare and Medicaid Services.

Don't forget about your deductible. That's what you pay before your insurance kicks in. For 2026, the most you can be charged out-of-pocket is $10,600 for individuals and $21,200 for families. Think of these as your financial safety net against catastrophic bills, but you'll pay thousands before you hit them.

Here's what most people don't realize: you need to add everything up. Take your annual premiums, deductible, copays and coinsurance to see what you're really spending. A plan with cheap monthly premiums usually means expensive doctor visits, while higher premiums typically mean you'll pay less when you're sick.

Plan Types and Networks

Marketplace plans come in four metal tiers (Bronze, Silver, Gold and Platinum) that basically decide how you and your insurer split the bill. Bronze plans have the lowest monthly premiums, but you'll pay the most when you need care. Silver plans sit in the middle. Gold plans cost more each month but less at the doctor. Platinum plans flip Bronze completely, with the highest premiums but lowest costs when you're actually using your insurance.

The tier doesn't affect the quality of care. All Marketplace plans cover the same 10 essential health benefits, including preventive services. It's just about who pays what percentage when you get medical care.

Make sure your doctor actually takes the plan you're considering. Some plans lock you into specific networks, and seeing an out-of-network provider can cost you two or three times more than staying in-network.

Eligibility Requirements

You can get Marketplace coverage if you live in the U.S., you're a citizen or lawfully present, and you're not incarcerated. If you're already on Medicare, you can't sign up for a Marketplace plan.

Your income decides whether you get premium tax credits that lower your monthly bill. Most people buying Marketplace plans get some help, though how much depends on what you earn and how many people are in your household.

Certain life changes let you enroll outside the regular enrollment window. Losing job coverage, getting married, having a baby or moving to a new state all open up special enrollment periods so you can sign up mid-year. Without one of these qualifying events, you're looking at limited options until open enrollment rolls around again.

Which Health Insurance Option Is Right for You in Case You Miss Open Enrollment?

Losing your job is stressful enough without worrying about health insurance. You're probably wondering if you can afford COBRA or if there's something cheaper. Maybe your income dropped and Medicaid could work. Or you're starting a new job soon and trying to figure out if you should wait. It comes down to two things: how much you can spend and how quickly you need coverage.


Lost job-based coverage	Marketplace plan through Special Enrollment Period	Tax credits can lower your monthly costs significantly if your income is between 100-400% of the federal poverty level.
Low income in expansion states	Medicaid	You can apply anytime and get covered at little to no cost. Some states even cover medical bills from the past three months.
Children who don't qualify for Medicaid	CHIP	Your kids get affordable coverage year-round without waiting for open enrollment.
Want to keep your current plan	COBRA	Same doctors, same coverage. You'll just pay the full premium instead of splitting it with your employer.
COBRA running out	Marketplace plan through Special Enrollment Period	Subsidies based on your current income often make Marketplace plans cheaper than what you're paying for COBRA.
Starting a new job	Employer-sponsored coverage	Your company typically covers a larger part of the premium, making this cheaper than buying coverage on your own.
Temporary gap in coverage	Short-term health insurance	Monthly premiums run lower, but pre-existing conditions aren't covered at all.

Bottom Line

You're not stuck without coverage just because you missed open enrollment. Life changes, like losing your job or having a baby, open Special Enrollment Periods. Low income? Medicaid and CHIP accept applications year-round. Add up your premiums, deductibles and what you'll actually pay when you need care to find affordable coverage.

Getting Health Insurance After Open Enrollment Ends: FAQ

Missing open enrollment doesn't mean you're out of options for health insurance. We've answered frequently asked questions about getting coverage after the deadline:

Can I still get health insurance if I missed the open enrollment period?

You can buy health insurance after the open enrollment period ends through Special Enrollment Periods triggered by qualifying life events, Medicaid or CHIP with year-round enrollment, employer-sponsored plans when starting a new job, or COBRA coverage after losing job-based insurance.

How long do I have to enroll after a qualifying life event?

You have 60 days after most qualifying life events to enroll in a Marketplace plan through a Special Enrollment Period. Submit required documentation within 30 days of selecting your plan. Your coverage start date depends on when you complete enrollment.

Does Medicaid cover medical bills from before I enrolled?

Medicaid may cover medical costs from the three months before your enrollment, even if you weren't enrolled when you received care. This backdated coverage depends on your family's income at the time you got medical care.

Can I get health insurance if I'm starting a new job soon?

Most employers offer coverage 30 to 90 days after your start date. For gap coverage before employer insurance begins, consider short-term health plans or checking if you qualify for Medicaid based on your current income during your waiting period.

What happens if I enroll in a Marketplace plan mid-month?

Coverage typically starts the first day of the month after you enroll through a Special Enrollment Period. If you enroll by the 15th of the month, coverage may start on the first of the next month. Check your specific plan documents for exact start dates.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. With over five years of experience analyzing the insurance market, he conducts original research and creates tailored content for all types of buyers. His insights have been featured in publications like CNBC, NBC News and Mashable.

Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!

He writes about economics and insurance, breaking down complex topics so people know what they're buying.

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sources

Healthcare.gov. "When can you get health insurance?." Accessed November 13, 2025.
Healthcare.gov. "Special Enrollment Opportunities." Accessed November 13, 2025.
Healthcare.gov. "Special Enrollment Periods for Complex Issues." Accessed November 13, 2025.
CMS.gov. "Plan Year 2026 Marketplace Plans and Prices Fact Sheet." Accessed November 13, 2025.