Quick answer: A Special Enrollment Period lets you sign up for or change a Marketplace (ACA) plan outside of Open Enrollment after certain life events, such as losing health coverage, moving, getting married, or having or adopting a child. In most cases you have 60 days from the event to pick a plan, and for a loss of coverage you can often apply up to 60 days before it ends. HealthCare.gov decides who qualifies.
If you live in Daytona Beach, Ormond Beach, Port Orange, Deltona, DeLand, New Smyrna Beach or anywhere in Volusia County and just had a life change, do not wait. The window is short, and missing it can leave you uninsured until next year.
Life events that may qualify
- Losing health coverage: a job ends, employer coverage ends, you age off a parent’s plan at 26, or you lose Medicaid. Dropping coverage on purpose or losing it for not paying premiums does not count.
- Moving: a permanent move to a new county or ZIP code with different plans. You usually need to have had qualifying coverage before the move.
- Marriage: coverage can start the first of the month after you pick a plan.
- Birth, adoption, or foster placement: coverage can start the day of the event.
- Other changes: divorce with loss of coverage, gaining citizenship, leaving incarceration, and some income changes.
How fast you need to act
Write down the date of the event and the date your old coverage ends. Most Special Enrollment Periods give you 60 days after the event. For a loss of coverage, you can usually report it up to 60 days before your plan ends so there is no gap. Apply as soon as you know the date.
What to gather
- Names, birth dates and Social Security numbers for everyone in the household
- Proof of the event, such as a termination letter, marriage certificate, birth record, or lease
- Your best estimate of household income for the year
- Your doctors, medications and preferred pharmacy
Subsidies and cost
Premium tax credits are based on household size and estimated income. The enhanced subsidies expired after 2025, so the 400% of poverty limit is back. For 2026 coverage, that limit is about $62,600 for a single person and $128,600 for a family of four. Above it, you pay full price. Lower incomes may also qualify for cost sharing reductions on Silver plans. Report income changes during the year so your credit stays accurate.
Marketplace plans vs short term medical
They are not the same. Short term plans are not ACA compliant, can deny you for health conditions, and often exclude pre existing conditions, maternity and prescriptions. Health care sharing ministries are not insurance at all. If you qualify for a Special Enrollment Period, look at Marketplace plans first. Learn more on our short term health insurance page.
Local help in South Daytona
USA Benefits Group (HealthBrokerFL) is an independent agency at 913 Big Tree Road in South Daytona. I have been licensed for 14 years, and we are appointed with 80+ insurance companies and licensed in 30+ states. We compare the Marketplace plans in your county side by side, check your doctors and drugs, and help with the application. There is no cost to you because the insurance company pays us.
Call or text 386-401-5644 or email ncurry@healthbrokerfl.com. Office hours are Monday to Friday 9am to 6pm, and Saturday by appointment. Missed the fall window with no life event? See ACA Open Enrollment in Daytona.
Turning 65 or already on Medicare?
A Marketplace Special Enrollment Period is not Medicare enrollment. If you are turning 65, start with turning 65 in Volusia County.
Frequently asked questions
What is an ACA Special Enrollment Period?
A window outside Open Enrollment to sign up for or change a Marketplace plan after a qualifying life event.
How long do I have after losing my health insurance?
Usually 60 days after the coverage ends, and you can often apply up to 60 days before it ends.
Does moving to Volusia County qualify?
A permanent move to an area with different plans can qualify, usually if you had qualifying coverage before the move.
Can I get subsidies during a Special Enrollment Period?
Yes, if your household income qualifies. The same tax credit rules apply as in Open Enrollment.
Is short term medical the same as an ACA plan?
No. Short term plans are not ACA compliant and can deny you based on your health.
Does it cost extra to use your agency?
No. There is no cost to you because the insurance company pays us.
HealthCare.gov makes all eligibility and subsidy decisions. Plan availability and prices vary by county.