Qualifying Life Events (QLEs) For 2026 Plan Year

Key Takeaways

A qualifying life event gives you 60 days to enroll in or change Marketplace plans outside open enrollment.

Marriage, having a child, moving or losing coverage typically qualify you for a Special Enrollment Period.

If you don't qualify, consider Medicaid, CHIP or short-term plans until open enrollment begins.

What Is a Qualifying Life Event (QLE)?

A qualifying life event (QLE) is a real-life change that opens a Special Enrollment Period, letting you enroll in or update a Marketplace plan after open enrollment ends. Think about changes like losing health coverage, getting married, having or adopting a child or moving to a new coverage area: these often count as QLEs. Most give you 60 days from the event to act.

But not every change qualifies. For example, choosing to drop coverage or losing it because you stopped paying premiums usually doesn’t create a QLE.

Types of Qualifying Life Events

There are times in life when things shift, and those changes can open a short window to update or choose a new Marketplace plan. These moments are called qualifying life events, and they usually relate to your family, your home or your coverage.

A new marriage or the arrival of a child often creates a chance to adjust your plan. Moving to a different area or losing the insurance you already had can also open that window. Some states treat pregnancy as a qualifying event too. The idea is simple. When your life changes in a way that affects your health coverage, the Marketplace gives you an opportunity to make sure your plan still fits.

When your household changes

Big family moments usually come with new financial and health needs. If you just got married, you and your spouse can pick a plan that fits both of you. When a child joins your family through birth, adoption or foster care, you can start their coverage from the day they arrive as long as you enroll within the allowed time. A divorce or the loss of a family member also creates an enrollment opportunity if it leaves you without the coverage you had before.

When you move

A new home can change the insurance options available to you. Moving to a different ZIP code or county, or returning to the United States after living abroad, lets you look at new Marketplace plans. Students who move for school and workers whose jobs send them to a new location usually qualify too. Moves made only for medical treatment or vacation do not count, and some people are asked to show that they had coverage before moving unless they are coming from outside the country.

When you lose health insurance

Losing coverage is stressful, and the Marketplace gives you a way to stay protected during that transition. If your job-based plan ends, if you turn 26 and come off a parent’s plan or if your private plan ends, you can choose a new Marketplace option. Losing Medicaid or CHIP after an eligibility change counts as well. Losing premium-free Medicare Part A qualifies, although losing Medicare because you fell behind on payments does not.

Changes in coverage through family

If you’re on another person’s plan, changes in their life can affect your own coverage. Turning 26, going through a divorce, losing a family member or losing coverage because that person’s insurance ended are all situations that open a chance for you to enroll in a new plan that fits your needs.

When your job benefits change

Some workplaces offer an individual coverage HRA or a Qualified Small Employer HRA. If you recently received that offer, or if you’ve been told you’ll receive one soon, you can shop for a Marketplace plan that works with it.

Other situations that count

A few other changes also open enrollment opportunities. Becoming a U.S. citizen, becoming a member of a federally recognized tribe, being released from jail or prison or having a change in AmeriCorps service can all create an opening to enroll.

IS PREGNANCY CONSIDERED A QUALIFYING LIFE EVENT?

Getting pregnant won't automatically give you a chance to switch health plans under normal federal rules, but some states have your back with extra protection. If you're expecting and live in one of these states, you'll get a short window to find a plan with better pregnancy and birth coverage - which can be a real lifesaver when your healthcare needs are changing fast. If you live in one of the states below, you can switch to a plan that better fits your care during pregnancy:

New York
Connecticut
Washington, D.C.
New Jersey
Maryland
Maine
Rhode Island
Colorado
Vermont

How Long Do You Have to Switch to a New Plan After Qualifying Event?

A qualifying life change that affects your coverage gives you a short window to switch plans, and that window moves fast. In most cases, you’ll have 60 days from the event to choose a new Marketplace plan. Some situations even let you take action earlier, giving you up to 60 days before the change to look at plans and prepare.

Timing matters, and it can feel like a lot when everything else is happening at once. So what does this mean for you?

If you pick a plan by the 15th of the month, your new coverage starts on the first day of the next month. HealthCare.gov has also made this rule more flexible, which makes it easier to get coverage started without extra delays.

Marriage, welcoming a new baby or bringing a child into your home through adoption or foster care all give you the chance to update your plan right away. Coverage can start on the day your family changes, as long as you choose a plan in time. These moments can be overwhelming already, so the Health Insurance Marketplace makes this easy.

Losing the insurance you relied on can feel unsettling, and coverage often starts right after that loss so you’re not left without care.

If you’re moving from Marketplace coverage to Medicare because of a life change, you get a two-month window to sign up. A few situations have slightly different timing, but most people follow this rule.

Changes tied to job benefits come with a shorter clock. Many workplaces give you about 30 days to pick a new plan, so check with your benefits team to make sure you don’t miss your deadline.

What Documentation Is Required for a Qualifying Life Event?

Updating your Marketplace plan after a major life change starts with sharing a bit of paperwork that shows what changed and when. Think of it as giving the Marketplace enough information to start your new coverage smoothly, not as jumping through hoops.


Family updates	Getting married calls for something simple like a marriage certificate or partnership form. Welcoming a child means sharing a birth certificate, adoption papers or foster placement paperwork. Anything that shows the day your family grew helps the Marketplace set the right start date.
Losing health insurance	A letter from your old plan explaining when your coverage ended is usually all you need. This applies whether you left a job, turned 26, or stopped being eligible through a spouse after a divorce. Losing coverage can feel overwhelming, and this step helps prevent gaps in care.
Moving to a new home	A move just requires proof of your new address. Many people use a lease, mortgage statement or a recent utility bill with their name and the date they moved in.
Death in the family	When someone on your plan passes away, a death certificate helps the Marketplace update your coverage and keep you protected during a difficult time.

What Options Do You Have If You Don’t Qualify for a Special Enrollment Period?

Missing a Special Enrollment Period can feel frustrating, especially if life already feels busy or uncertain. But you’re not out of options. You still have a few clear paths that can keep you covered until it’s time to choose a Marketplace plan again, and each one works differently depending on what’s happening in your world right now.

1
Medicaid or CHIP
If your income has taken a hit, maybe you lost your job, had hours cut, or you're handling unexpected expenses, Medicaid or CHIP can offer year-round coverage. Many people qualify even when they assume they won’t, and the application process is straightforward.
2
Short-term health plans
They’re meant for brief gaps and don’t include the full protections of Marketplace coverage, but they can keep you from being uninsured. Before choosing one, make sure the plan covers the essentials you rely on, since benefits vary widely.
3
Check if you qualify for a hardship or state-based option
Some states offer extra enrollment opportunities beyond federal rules. These usually apply during difficult circumstances, such as natural disasters or major disruptions in your life. If something unusual is happening, a quick call to your state Marketplace can tell you whether you can enroll sooner.
4
Plan ahead and stay ready
While you wait, staying organized helps. Keep track of any changes coming up, save documents you might need, and make a simple plan for Open Enrollment. A bit of preparation now can make the next chance to enroll feel far less stressful.

Bottom Line

Major life changes like marriage, having a child, moving or losing coverage trigger a qualifying life event that opens a 60-day enrollment window for Marketplace health plans. Missing this deadline doesn't leave you completely without options. Medicaid, CHIP and short-term plans can provide coverage until the next open enrollment period.

Qualifying Life Events for Insurance: FAQ

We've answered frequently asked questions about qualifying life events to help you understand your enrollment options:

How can you enroll in a plan after a qualifying life event?

Visit HealthCare.gov and report your qualifying life event during the application process. You'll have 60 days from the event to compare plans and select coverage. You'll need to provide documentation proving your qualifying event occurred to finalize enrollment.

Can I enroll before my qualifying life event happens?

Some qualifying events let you enroll up to 60 days before the change happens. Marriage and welcoming a new child through birth or adoption allow you to prepare early and start coverage from the day your family changes.

What if I miss the 60-day enrollment deadline?

You'll need to wait for Open Enrollment unless you qualify for Medicaid or CHIP based on your income. Short-term health plans can provide temporary coverage until Open Enrollment begins, though they don't include all Marketplace protections.

Does moving to a new apartment in the same city qualify?

Moving within the same ZIP code typically doesn't trigger a Special Enrollment Period since your available Marketplace plans remain the same. You need to move to a different ZIP code or county where different insurance options become available.

Can I switch plans multiple times if I have more than one qualifying event?

Yes, each qualifying life event opens its own 60-day Special Enrollment Period. If you experience multiple qualifying changes throughout the year, you can update or switch your plan each time, as long as you act within the deadline.

Will I be automatically enrolled in a plan after a qualifying life event?

No, you must actively enroll during your Special Enrollment Period. The qualifying life event opens a window for you to choose or change plans, but you'll need to complete the application process yourself within 60 days.

How can I verify if my situation qualifies before starting enrollment?

You can check your eligibility on HealthCare.gov by starting the enrollment process and answering questions about your situation. The system will confirm if your circumstances qualify for a Special Enrollment Period before you commit to selecting a plan.

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. "Qualifying life event (QLE)." Accessed November 17, 2025.
HealthCare.gov. "Special Enrollment Period (SEP)." Accessed November 17, 2025.
HealthCare.gov. "Special enrollment opportunities." Accessed November 17, 2025.