So you missed the Open Enrollment deadline. Now what?

The 2026 ACA Open Enrollment Period is now officially over in every state.

For most Americans, if you missed the deadline to enroll in ACA exchange healthcare coverage, your options are pretty limited at this point...but there are some exceptions, so let's take a look.

NATIVE AMERICANS / ALASKA NATIVES:

Members of federally-recognized Native American tribes or Alaska Natives can enroll in ACA coverage year-round:

If you’re an American Indian or an Alaska Native, you may have new health coverage benefits and protections in the Marketplace.

• Some benefits are available to members of federally recognized tribes or Alaska Native Claims Settlement Act (ANCSA) Corporation shareholders. See the list of federally recognized tribes.

• Others are available to people of Indian descent or otherwise eligible for services from the Indian Health Service, a tribal program, or an urban Indian health program.

Enroll in a Marketplace plan anytime

Members of federally recognized Tribes and ANCSA shareholders can enroll in a Marketplace plan at any time for coverage this year. Once you’re enrolled in a plan, you can change plans up to once a month or enroll for plan coverage next year during Open Enrollment.

Special health coverage protections and benefits for members of federally recognized Tribes and ANCSA shareholders

You can get health coverage through Marketplace plans, Medicaid, and the Children’s Health Insurance Program (CHIP). There are advantages to enrolling in Marketplace coverage:

• Access to a wider range of providers and services — in addition to health care services you get through Indian health care providers.

• You may qualify for a premium tax credit that lowers your monthly premium and extra savings when you get care (called “cost-sharing reductions”).

Marketplace

If you buy a Marketplace plan and your income is between 100% and 300% of the federal poverty level, you can enroll in a “zero cost sharing” plan. This means you won’t have to pay any out-of-pocket costs — like deductibles, copayments, and coinsurance — when you get care.

If you get services from an Indian health care provider, you won’t have any out-of-pocket costs, like deductibles, copayments, or coinsurance, regardless of your income.

Medicaid & CHIP benefits

You pay no premiums or out-of-pocket costs for Medicaid coverage if you’re eligible to get services from an Indian Health Service, Tribal programs, or urban Indian programs (known as I/T/Us) or Purchased or Referred Care (PRC) program.

Learn about protections under Medicaid and CHIP.

Getting services from Indian Health Service, Tribes and Tribal organizations, or urban Indian organizations

You may qualify for Medicaid and CHIP more easily. You have special cost and eligibility rules for Medicaid and the Children’s Health Insurance Program (CHIP) that make it easier to qualify for these programs.

Regardless of income, you won’t have any out-of-pocket costs for items or services provided by the Indian Health Service, Tribal programs, or urban Indian programs (known as I/T/Us).

Indian Health Service, Tribes and Tribal organizations, or urban Indian organizations and Marketplace insurance

If you enroll in a Marketplace plan, you can get (or keep getting) services from IHS, Tribes and Tribal organizations, or urban Indian organizations. You can also get services from any providers on the Marketplace plan.

MEDICAID & CHIP COVERAGE:

If you're eligible for Medicaid or the Children's Health Insurance Program (CHIP), you can enroll year-round.

Medicaid and the Children’s Health Insurance Program (CHIP) provide free or low-cost health coverage to eligible low-income adults, families and children, pregnant women, the elderly, and people with disabilities.

Even if you don't qualify for Medicaid based on income, you should apply. You might qualify for your state's program, especially if you have children, are pregnant, or have a disability. You can apply for Medicaid and CHIP any time of year.

Some states have expanded their Medicaid programs to cover all people with household incomes below a certain level. Others haven't.

Even if your state hasn't expanded Medicaid, you should fill out an application. Each state has coverage options that consider income, household size, family status (like pregnancy or caring for young children), disability, age, and other factors.

Apply for Medicaid and CHIP one of these ways:

• Fill out an application through the Marketplace

If it looks like anyone in your household qualifies for Medicaid or CHIP, we’ll securely send your information to your state agency. Your state will contact you about enrollment. When you submit your Marketplace application, you’ll also find out if you qualify for cost savings on a Marketplace plan.

If you’re denied Medicaid or CHIP coverage, your state securely sends your contact information to the Marketplace. We’ll use it to mail you a letter about getting Marketplace coverage.

• Apply directly through your state Medicaid agency

Select your state below to get your Medicaid agency’s contact information.

SPECIAL ENROLLMENT PERIODS:

You may be eligible for a 60-day Special Enrollment Period if you have a qualifying life event like losing your existing coverage, getting married/divorced, giving birth/adopting, turning 26, getting out of prison, etc.

A Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.

Depending on your Special Enrollment Period type, you usually have 60 days before or 60 days following the event to enroll in a plan.

Job-based plans must provide a Special Enrollment Period of at least 30 days.

Life changes

Special Enrollment Period details vary based on the life change:

Changes in household

You may qualify for a Special Enrollment Period if in the past 60 days you or anyone in your household:

• Got married. Pick a plan by the last day of the month and your coverage can start the first day of the next month.
• Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
• Got divorced or legally separated and lost health insurance. Divorce or legal separation without losing coverage doesn’t qualify you for a Special Enrollment Period.
• Died. You’ll qualify for a Special Enrollment Period if someone on your Marketplace plan dies which causes you to lose your current health plan.

Changes in residence

You may qualify for a Special Enrollment Period if you move to:

• A new home in a new ZIP code or county
• The U.S. from a foreign country or United States territory

Or, move to or from the:

• Place you attend school (if you're a student)
• Place you both live and work (if you're a seasonal worker)
• Shelter or other transitional housing

Moving only for medical treatment or staying somewhere for vacation doesn’t qualify you for a Special Enrollment Period.

You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You don't need to provide proof if you’re moving from a foreign country or United States territory.

Loss of health coverage

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days. (If you lost Medicaid or Children's Health Insurance Program (CHIP) coverage in the past 90 days, you may qualify for a Special Enrollment Period.)

• Job-based coverage
• Individual health coverage
• Medicaid or Children’s Health Insurance Program (CHIP) coverage (or were denied Medicaid/CHIP)
• Eligibility for Medicare
• Coverage through a family member

An employer offer to help with the cost of coverage

You may qualify for a Special Enrollment Period to enroll in Marketplace coverage if you (or anyone in your household) were offered an individual coverage Health Reimbursement Arrangement (HRA) or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days OR expect to in the next 60 days.

Your employer may refer to an individual coverage HRA by a different name, like “ICHRA." Get details about offers for individual coverage HRAs and Qualified Small Employer HRAs.

If you qualify, contact the Marketplace Call Center to complete your enrollment. You can’t do this online.

More qualifying changes

Other situations that may qualify you for a Special Enrollment Period:

• Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder

• Becoming a U.S. citizen

• Leaving incarceration

• Starting or ending service as an AmeriCorps State and National, VISTA, or National Civilian Community Corps (NCCC) member

• Being affected by an unexpected and uncontrollable event or natural disaster (like an earthquake, massive flooding, or a hurricane)

View other Special Enrollment Periods.

You may have to submit documents

When you apply, you must attest (agree) that the information you provide on the application is true, including the facts that qualify you for a Special Enrollment Period. You may have to submit documents that confirm your life event.

STATE-SPECIFIC PROGRAMS:

There are also several state-specific programs which also allow eligible enrollees to do so outside of the official Open Enrollment Period:

• Connecticut: Special Enrollment Period

(for residents earning 100 - 200% FPL or 400 - 500% FPL only)

Access Health CT (AHCT), Connecticut’s official health insurance marketplace, today announced it will offer a Special Enrollment Period for eligible customers to enroll in health coverage with the new state subsidy starting Feb. 1. The end date for the Special Enrollment Period is to be determined. The Special Enrollment Period is separate from the Open Enrollment Period, which ends Jan. 31.

...Customers who qualify for this Special Enrollment Period include:

• Households with an annual income between 100% and 200% of the Federal Poverty Level (FPL), who are not already enrolled in the Covered CT Program. These customers will receive a state subsidy to replace 100% of the expired federal enhanced premium tax credit amounts.

• Households with an annual income over 400% and up to 500% FPL. These customers will receive a state subsidy to replace 50% of the expired federal enhanced premium tax credit amounts.

Eligible customers who have already enrolled or plan to enroll in a health plan for 2026 will see a credit applied through their carrier bill.

• Connecticut: Covered Connecticut

The CoveredCT program offers no-cost health insurance, dental insurance and non-emergency medical transportation to all Connecticut residents between the ages of 19-64 that qualify. Connecticut residents can apply and enroll if eligible, at any time during the year, there does not have to be a qualifying life event to enroll. To qualify, Connecticut residents must:

• have a household income up to an including 175% of the Federal Poverty Level and be ineligible for HUSKY Health/Medicaid due to income;

• are eligible for financial help to purchase health insurance on the Connecticut Health Insurance Exchange, Access Health CT, using 100% of available Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs);

• enroll in a Silver-Level Plan on the Connecticut Health Insurance Exchange, Access Health CT.

• Massachusetts: ConnectorCare

ConnectorCare plans have $0 or low monthly premiums, low out-of-pocket costs, and no deductibles. Plus, you may be able to fill certain prescription medicines at no cost for chronic health conditions like asthma, coronary artery disease (a type of heart disease), diabetes, hypertension (high blood pressure), and opioid addiction.

What kind of coverage do you get with ConnectorCare?

ConnectorCare plans offer great coverage with important benefits like doctor visits, prescription medications, and emergency care. ConnectorCare plans have low monthly premiums, low co-pays, and no deductibles. There are different ConnectorCare Plan Types, which are based on your income. All of the plans offered for each Plan Type will have the same benefits and co-pays for covered services. You can see the co-pays for different services for 2026 in the chart found here for each Plan Type. You can also see examples of the monthly premiums for each Plan Type below.

ConnectorCare plans are offered by some of the leading insurers in the state. Each insurer’s plan may have different doctors or hospitals in its provider network. Before you enroll, use our online tools to see if the providers you want and the prescription drugs that you need are covered in the plan’s network.

...Who can qualify for a ConnectorCare plan?

For the 2026 plan year, people with household incomes that are between 100% and 400% of the Federal Poverty Level (FPL) may qualify for ConnectorCare. If your income is higher than the income limit for the plan year, you won’t qualify for a ConnectorCare plan.

To qualify for a ConnectorCare plan, you will need you will also need to meet the following requirements:

• Live in Massachusetts
• Be a US Citizen, National, or lawfully present immigrant in the United States
• Not have access to an employer’s affordable, comprehensive health insurance (including plans you are offered, but are not enrolled in)
• Not be in jail or prison
• Not qualify for Medicare, MassHealth (Medicaid), or other public health insurance programs

You may be able to enroll in coverage through the Health Connector if you qualify for certain types of coverage or experience certain life events (called “qualifying events”) that may allow you to get coverage during a 60-day special enrollment period, even after Open Enrollment ends.

You can enroll any time of the year if:

• You qualify for MassHealth.
• You now qualify for a ConnectorCare plan through the Health Connector after not having qualified in the past, or after applying for the first time.
• You are applying for dental coverage.
• You are a member of a federally recognized tribe or Alaska Native shareholder.
• You have a waiver from the Office of Patient Protection

• District of Columbia: Extended Special Enrollment Period

You now have until midnight on February 4 to enroll in a plan for 2026. Shop, compare, and save on a plan that meets your needs and budget.

The District of Columbia, Minnesota, New York and Oregon all have special Basic Health Plan programs available to residents who earn between 138 - 200% of the Federal Poverty Level, and which eligible residents can enroll in YEAR ROUND:

The Basic Health Program (BHP) – section 1331 of the ACA – allows states to create a coverage program for adults with household income between 138% and 200% of the federal poverty level (FPL).1 Like Medicaid, enrollment in a BHP is available year-round for eligible applicants.

The ACA's Medicaid expansion, which most states have implemented, covers adults with household income up to 138% of FPL. In states that implement a BHP, eligibility picks up where Medicaid expansion ends, and extends to 200% of FPL. States can fund a BHP using federal funding that would otherwise have been spent on Marketplace premium subsidies for those enrollees. The federal government will give the state 95% of the amount the federal government would otherwise have spent on subsidies, and the state can supplement that funding with additional state funding.

• District of Columbia: Healthy DC Basic Health Plan

The Healthy DC Plan is quality health coverage for DC residents who have moderate incomes. There are no monthly premiums and no out-of-pocket costs for covered care. All plans cover doctor visits, urgent care visits, hospital stays, prescription drugs, mental health care, and more.

Who is eligible for Healthy DC Plan?

DC residents are eligible for Healthy DC Plan if they are:

• 21-64 years old;
• US Citizen or lawfully present;
• Not eligible for Medicaid;
• Not eligible for employer or other coverage; and
• Have an annual income between 138% and 200% of the Federal Poverty Level.

• Special eligibility for lawfully present residents with an annual income between 100% and 138% of the Federal Poverty Level: If a lawfully present resident is not eligible for Medicaid due to immigration status, the resident is eligible for Healthy DC Plan.

• Important information about pregnancy: If you become pregnant, you will no longer be eligible for Healthy DC Plan. Medicaid will cover you, including delivery and 12 months of post-partum care.

• Minnesota: MinnesotaCare Basic Health Plan

MinnesotaCare is a health care program for Minnesotans with low incomes. To find out whether you qualify for MinnesotaCare, you must apply.

Enrollees get health care services through a health plan or on a fee-for-service basis.

Most enrollees get health care through a health plan. You can choose your health plan from those available in the county where you live.

Enrollees who do not get health care through a health plan get care on a fee-for-service basis, with providers billing the state directly for services they provide.

MinnesotaCare is funded by a state tax on Minnesota hospitals and health care providers, federal Basic Health Program funding and enrollee premiums.

The information on this page does not cover all program rules.

• New York: Essential Plan Basic Health Plan

(note: NY's Essential Plan income cut-off is 250% FPL until the end of June; starting July 1st, 2026 it will revert back to the same 200% FPL cut-off as the other BHP states)

NY State of Health's Essential Plan includes comprehensive benefits with $0 monthly premiums and very low-cost sharing. The Essential Plan:

Has no deductible, so the plan starts paying for your health care right away.

Covers comprehensive benefits, including dental and vision, inpatient and outpatient hospital care, prescription drugs and more.

Covers free preventive care like routine exams and screenings.

Has continuous open enrollment, meaning you can enroll at any time during the year through NY State of Health.

Individuals are eligible for the Essential Plan if they are:

• New York State residents
• Lawfully present in the U.S.
• 19-64 years old
• Not eligible for Medicaid or Child Health Plus
• Not eligible for employer and other coverage
• Able to meet the Essential Plan annual income requirements listed in the table below

• Oregon: Bridge Program Basic Health Plan

What Is It?

OHP Bridge is a new health coverage benefit for adults with income just above the traditional OHP Plus limit. Adults with annual income between 133 and 200 percent of the federal poverty level (FPL) will have access to quality health insurance through OHP Bridge.

OHP Bridge will cover medical, dental and behavioral health care. Members will have access to additional benefits, like transportation to medical apointments and health-related services. However, OHP Bridge will not cover long-term services and supports or climate and housing benefits.

Just like OHP Plus, OHP Bridge has no member costs. That means no premiums, no co-payments, no coinsurance and no deductibles.

Who Is This For?

OHP Bridge will cover adults up to age 65 who:

• Have income above traditional OHP Plus limits and between 133 to 200 percent of the FPL,
• Do not have access to affordable health insurance, and
• Have an eligible citizenship or immigration status to qualify.