Special Enrollment Period
You may qualify to enroll in 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, review the health plans in your area.
2022 Special Enrollment Period
You have two set times each year to buy a BCBSTX health plan. One is the Open Enrollment Period (OEP), when everyone can buy a health plan. Generally, OEP is from November 1 through December 15 of the same year. This year’s OEP was from November 1, 2021 – January 15, 2022. The other is called the Special Enrollment Period (SEP). The SEP runs from the time the OEP ends until it starts again in November.
In order to qualify for SEP, you’ll need to show proof that you had a qualifying life event within the past 60 days.
Important Information About SEP
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 888-731-0406 with any questions.
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:
You May Qualify for a Subsidy
Good news - health care coverage may be more affordable than you think.
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.
SEP Qualifying Events
There are many kinds of life events that may qualify you for special enrollment, like:
- You have or adopt a child or gain a dependent through a court-order
- The policy holder passed away
- You move to a new area that provides you different plans or isn't covered by your HMO network
- You get married
- You are no longer covered on a family member's policy because you turned 26
- You have legally separated from or divorced your spouse
- You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons1
- Your income or household status changes
- Your employer offered to help with the cost of coverage (through an ICHRA or QSEHRA)
- Your current health care coverage is ending on a date other than December 31st of the current plan year
- You become a U.S. citizen2
- You can prove that your health insurance company violated its contract with you
- You become a member of an American Indian and Alaska Native tribe2
- You experience an error or other issue when trying to enroll
- Your annual individual or household income is at or below 150% of the federal poverty level
View a full list of qualifying events.
Not All Life Events Qualify for SEP Enrollment
Non-qualifying events may be:
- Choosing not to get health care coverage from your job
- Travel insurance expiring
- Loss of a short-term or temporary health plan3
- Gaining voluntary guardianship of a dependent (not authorized by a court)
- Choosing to cancel your health plan before its renewal or end date
- Loss of state or federal health care coverage or assistance due to not supplying needed documents as proof
- Ending participation in a Medical Cost Sharing Group
You can always call us at 888-731-0406 or use the contact form if you have questions or need help.
Applying During SEP
You have three ways to buy your plan during this new SEP
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.
Other Health Care Coverage Options
You may also qualify for Medicaid, Children’s Health Insurance Program (CHIP) or other assistance based on your income. These health care coverage options are 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.
Get Your BCBSTX Health Plan
Review the health care plans in your area.
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.