What might be a reason for someone to qualify for a Special Election Period?

A person may qualify for a Special Election Period (SEP) when they move outside their current plan’s service area because this type of change affects their access to services and providers covered under their existing health plan. When an individual relocates and their new residence falls outside the geographic boundaries where their current health plan provides coverage, they gain the right to enroll in a new plan that is accessible in their new location. This ensures that individuals have continuous access to necessary healthcare services and support when their circumstances change significantly.

While having a chronic condition, reaching a maximum out-of-pocket limit, or experiencing a significant change in income are important factors that can influence a person’s healthcare choices or need for assistance, they do not typically trigger an SEP. Those changes could represent important considerations for health plan selection during the regular enrollment period, but they are not specific events that permit an individual to enroll outside of the standard enrollment timeline like a change in residency does.