GETTING ENROLLED
Health insurance isn’t one-size-fits-all—and timing matters. You can enroll when you turn 26, switch jobs, move states, experience a major life event, or during open enrollment each year.
Not sure if it’s your time or how to get started? Check out the resources below to find out what fits your situation.
Turning 26
If you've been covered under a parent or guardian’s health insurance plan, turning 26 means you may need to find your own coverage (unless you qualify for an exception in some states). Losing coverage under a parent or guardian’s plan qualifies as a Special Enrollment Period (SEP)—allowing you 60 days before and after your coverage ends to enroll in a new health plan.
Here’s what you need to know:
You have options for healthcare coverage!
Not sure where to start? Apply for Insurance Navigation through our Treatment Access application for 1:1 communication with our Insurance Navigation Program Manager.
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If you have a job that offers health insurance, this is often the most affordable and convenient option. Some employers allow you to join their plan as soon as you lose coverage under your parent's plan.
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You can apply for a plan through HealthCare.gov or your state’s marketplace. Losing coverage at 26 qualifies you for a Special Enrollment Period (SEP), meaning you don’t have to wait for open enrollment. Depending on your income, you may qualify for subsidies that lower your premium costs.
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If your income is low, you’re over the age of 65, or have a qualifying disability, you may be eligible for coverage through a government plan.
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You may be able to stay on your parent's employer-based plan for up to 36 months through COBRA, but this is often expensive since you must pay the full premium.
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These plans are a temporary, lower-cost option but usually offer limited coverage. They don’t cover pre-existing conditions and aren’t ACA-compliant.
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If you're a college or graduate student, your school may offer a health insurance plan.
The Insurance Marketplace
The Affordable Care Act (ACA), also known as Obamacare, was designed to make health insurance more accessible and affordable through the Health Insurance Marketplace. The ACA promotes a competitive insurance market, allowing individuals and small businesses to compare and purchase coverage in one place. You can enroll in a Marketplace plan during the Open Enrollment Period each year. However, if you experience a qualifying life event, you may be eligible for a Special Enrollment Period outside this period.
The Marketplace offers various plans with different provider networks, deductibles, and costs, making it easier to compare options and find the best fit.
Visit the Marketplace and find the best fit for you.
Frequently-Asked Questions About the Marketplace
If you have questions about the marketplace, check out our frequently-asked questions.
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You can apply for a Marketplace plan during:
Open Enrollment: This occurs annually in the fall (typically Nov 1 – Jan 15, though dates may vary by state). Coverage begins Jan 1 of the following year.
Special Enrollment: If you experience a qualifying life event—such as losing coverage, getting married, having a baby, or moving—you may be eligible to enroll within 60 days of the event.
Medicaid or CHIP: You can enroll anytime if you qualify. If denied Medicaid/CHIP after Open Enrollment, you may apply for Marketplace insurance.
Native Americans: Members of federally recognized tribes can enroll at any time
Residents of NY, MN, and MA with “fairly low income”: New York (the Essential Plan) and Minnesota (MinnesotaCare) both offer year-round enrollment and are available to residents with income up to 200% of the poverty level. Massachusetts (ConnectorCare) is available to residents with income up to 300% of the poverty level.
⚠ Note: Losing short-term health insurance does not qualify as a special enrollment event.
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You can update your information in the Marketplace online, by phone, or in person—not by mail. It’s important to report changes promptly, as they may affect your coverage and savings.
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The fastest way is uploading them online. You can also send documents via mail.
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You must pay your premium directly to your insurance company—not through the Marketplace. Coverage will not start until the first premium is paid.
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You can apply for coverage in several ways:
Online at HealthCare.gov (the easiest option)
By phone
Through an agent or broker
Via certified enrollment partner websites
With a paper application
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To be eligible for marketplace coverage, you must…
✔ Live in the U.S.
✔ Be a U.S. citizen, national, or lawfully present resident
✔ Not be incarcerated (you can apply upon release)
✔ Not have an active Medicare plan✔ You can have both a Marketplace plan and Medicaid, but if enrolled in Medicaid, you’re not eligible for premium tax credits or cost savings on a Marketplace plan.
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ACA-compliant plans cannot deny coverage based on pre-existing conditions and must cover at least 10 essential health benefits:
Outpatient care
Prescription drugs
Emergency services
Mental health & addiction treatment
Hospitalization
Rehabilitative services & devices
Preventive, wellness & chronic disease care
Laboratory services
Pediatric care
Maternity & newborn care
To enroll in an ACA plan, you must sign up during Open or Special Enrollment. Short-term medical plans are typically less expensive but are not ACA-compliant and do not cover pre-existing conditions.
Open Enrollment
The Open Enrollment Period is the annual time when individuals can enroll in, renew, or change their health insurance plans. The exact dates depend on the type of insurance and varies by state, especially for those with their own health insurance marketplaces.
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Private Plans
Employers set their own Open Enrollment dates, often in the fall (October–December) for coverage beginning January 1. Check with your HR team to see when you can get enrolled or change your insurance plan.
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Insurance Marketplace Plans
The typical enrollment period is from Nov 1 - Jan 15, with coverage starting the following year. For up-to-date information, use the guide provided by HealthCare.gov.
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Government Plans
Enrollment periods will vary depending on the state and plan you are pursuing. Medicare’s annual enrollment is from October 15 - December 7; Medicare Advantage Open Enrollment is open from January 1 - March 31; and Medicaid and CHIP are open year-round for those who qualify based on income or other eligibility criteria.
Special Enrollment Period (SEP)
If you miss open enrollment, you may qualify for a Special Enrollment Period (SEP) if you have a qualifying life event, such as:
Losing employer coverage
Moving to a new state
Getting married or divorced
Having a baby
Let Project HEAL Help Walk You Through the Steps of Enrollment
Still feeling overwhelmed by getting enrolled? Check out the videos from Project HEAL that walk you through the steps to getting health insurance coverage during the open enrollment period.