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Individual & Family

FAQs: Special Enrollment

From going through a big change to enrolling with BCBSTX, we're here to answer questions. What should you know about Special Enrollment?

  • Most people have 60 days after their life event to enroll
  • You may need proof of event and/or proof of prior coverage
  • Missed SEP? Open Enrollment starts Nov. 1
Understand Special Enrollment
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What is Special Enrollment and what do I do if I qualify?

The Special Enrollment period is a chance for you to enroll in a new health insurance plan after goring through a big life change, like moving, getting married or having a baby. During Special Enrollment, you can also choose to update your current coverage instead of choosing a new health care plan.1 

In this guide:

  • Learn when and how you can enroll in coverage
  • If you'll need to submit documents proving your life event
  • Find answers to frequently asked questions about the Special Enrollment Period.

ELIGIBILITY

How do I know if I can enroll during Special Enrollment?

If you go through a "qualifying life event," you're eligible for Special Enrollment. Qualifying life events are big life changes that impact health coverage for you or your family. Learn more about some common qualifying life events:

How can I enroll during Special Enrollment?

Afer you've made sure you qualify, enroll with an insurer like BCBSTX within 60 days of your event happening. If you're ready to compare your BCBSTX options, visit our shopping platform to get started.

Get Started
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PLAN SELECTION

Can I switch to a better plan during Special Enrollment?

You can. A life change often means the needs of you or your family change. Special Enrollment is the perfect chance to update your plan to coverage that better fit these needs:

  • Choose a plan with lower costs
  • Explore plans with different benefits
  • Add a dependent or a spouse to your coverage

Documentation

Do I need to show proof of my event or health insurance coverage?

Depending on your life event, you may need to submit some documentation. These documents normally fall into 1 of 2 categories:

Check Valid Documents
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Proof of your life event

These documents show when your life event was. A few examples are a marriage license, birth certificate or letter from your employer.

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Proof that you had insurance

Depending on the documents you submit, you may also need to send proof of insurance like a letter from your insurer or certificate of Credible Coverage.

Check Valid Documents
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What happens if I miss my Special Enrollment deadline?

Can I still get insurance?

You normally have 60 days after your life event to enroll through Special Enrollment. If you miss that deadline, you may have to wait until Open Enrollment, beginning November 1.

You can also check if you qualify for Medicare or Medicaid plans. These plans are offered by the government. Eligibility is based on age, income or disability.

Frequently Asked Questions About Special Enrollment

1Members of American Indian and Alaska Native tribes can apply for health care coverage any month of the year. If you qualify for Children’s Health Insurance Program (CHIP) or other assistance based on your income, you do not need to enroll during the Special Enrollment Period.

2The following are not considered loss of coverage: voluntarily canceling your health insurance plan, having your plan canceled because you did not pay your premiums or because your plan did not meet the requirements set by the Affordable Care Act for Minimum Essential Coverage.

BCBSTX does not offer temporary or short-term plans. These plans may not provide the full benefits of a BCBSTX health plan, including essential health benefits.