SPECIAL ENROLLMENT PERIOD

You may qualify to buy a Blue Cross and Blue Shield of Texas (BCBSTX) health plan outside of the annual Open Enrollment Period (OEP) during the Special Enrollment Period (SEP). To be eligible, you must have had a qualifying life event within the past 60 days.

FIND YOUR BCBSTX HEALTH PLAN

If you qualify for SEP, take a look at the health plans in your area.

Start Shopping Now

YOUR SPECIAL ENROLLMENT PERIOD

You have two set times each year to buy a health plan. One is the Open Enrollment Period (OEP). This is most often November 1 – December 15 and is the time when everyone can buy a health plan. The other is called the Special Enrollment Period (SEP). The SEP runs from the time OEP ends and starts again the next year.

You must qualify for SEP with a qualifying life event, such as losing your current health care coverage due to job loss or getting married. You’ll just need to send in proof showing that you had a qualifying life event and your event’s date. Based on your income and family size, you may also be able to get financial help.

If you have a BCBSTX health plan, you may be able to change your plan during a SEP as well.

SEP QUALIFYING LIFE EVENTS

There are many kinds of life events that qualify for a special enrollment.

Qualifying events may be:

• You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.¹
• Your current health care coverage is ending on a date other than December 31st of the current plan year.
• You move to a new area that provides you different plans or isn't covered by your HMO network.
• You get married.
• You have or adopt a child or gain a dependent through a court-order.
• You become a U.S. citizen.²
• Your income or household status changes.
• You can prove that your health insurance company violated its contract with you.
• You are no longer covered on a family member's policy because you turned 26.
• You have legally separated from or divorced your spouse.
• The policy holder passed away.
• You become a member of an American Indian and Alaska Native tribe.²
• You experience an error or other issue when trying to enroll .
• Your employer offered to help with the cost of coverage (through an ICHRA or QSEHRA).

View a full list of qualifying events .

Non-qualifying events may be:

• Choosing not to get health care coverage from your job.
• Choosing to cancel your health plan before its renewal or end date.
• Travel insurance expiring.
• Loss of State or Federal health care coverage or assistance due to not supplying needed documents as proof.
• Loss of a short-term or temporary health plan.³
• Ending participation in a Medical Cost Sharing Group.
• Gaining voluntary guardianship of a dependent (not authorized by a court).

You can always call us at 1-888-697-0683 or use the form below if you have questions.

APPLYING DURING SEP

If your life event qualifies you to get health care coverage in a special enrollment, you have three ways to buy your plan:

• Online - You can buy your health plan on our website.
• Phone - Call 1-888-731-0406 to speak with a BCBSTX licensed sales representative.
• Agent – Work with an independent, authorized agent to sign you up.

While your application is being reviewed, we’ll send you a letter if more documentation is needed. You’ll have 30 days from this letter’s date to reply.

IMPORTANT INFORMATION WHEN APPLYING

Deadlines

In most cases, you have 60 days (including weekends and holidays) from the date of your qualifying life event to buy a new health plan.

Some qualifying events, like losing health care coverage due to job loss, may let you buy a plan up to 60 days before your event happens. Call us at 1-888-697-0683 with any questions.

Financial Help

You can check to see if you qualify for a subsidy, also known as a premium tax credit, while applying during SEP. This credit may help you lower the amount you’ll pay for your monthly premium bill.

Documentation

You'll need to send in documents, or proof, showing you had a qualifying life event and your life event date, such as a marriage or adoption certificate. View a full list of required documents .

COVERAGE START DATES AND PAYMENT

When you buy or change your health plan during the SEP, your health care coverage may not start right away. Your coverage start date is most often based on:

• Your qualifying life event and your event date
• The date you apply
• Making your first payment

IF YOU DON’T QUALIFY

If you can’t get health care coverage during SEP, you may still have options.

You may qualify for Medicaid , Children’s Health Insurance Program (CHIP) or other assistance based on your income. This health care coverage is provided by the government. There’s no SEP, so you can apply at any time. You may also qualify for financial help.

Note: Members of American Indian and Alaska Native tribes can apply for health care coverage any month of the year.

FIND YOUR BCBSTX HEALTH PLAN

If you qualify for SEP, take a look at the health care plans in your area.

Start Shopping Now

¹Please note that the 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.

²Only for health plans bought on the Marketplace.

³BCBSTX 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.