A qualifying life event (QLE) is a change in your life situation — such as getting married, having a baby, losing job-based coverage, or moving to a new state — that makes you eligible for a Special Enrollment Period (SEP) to sign up for or change health insurance outside of the annual Open Enrollment window.
Outside of the annual Open Enrollment Period (typically November 1 – January 15), you can only enroll in or change a marketplace health plan if you have a qualifying life event. A QLE triggers a Special Enrollment Period (SEP) that usually lasts 60 days from the date of the event. The HealthCare.gov SEP overview lists all recognized qualifying events.
When a QLE occurs, you generally have 60 days to enroll in a new plan. Log in to HealthCare.gov or your state's exchange, report the life event, and select a new plan. Coverage typically starts the first of the month after you enroll. Documentation may be required — for example, a termination letter from your prior insurer when losing job-based coverage.
Medicaid and CHIP (Children's Health Insurance Program) enrollment is open year-round — there is no enrollment window and no qualifying event requirement. If your income drops and you may now qualify for Medicaid, apply any time at your state Medicaid agency or via HealthCare.gov.
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