In general, a change in income that makes your current policy unaffordable will not qualify you for a special enrollment period.

However, if a decrease in your household income would make you eligible for a premium tax credit, you may have an opportunity to purchase coverage through the Marketplace outside of the annual open enrollment period. Similarly, if your income is in the “gap” between 100% and 133% of the Federal Poverty Level (FPL) and rises above 133% of the FPL, making you eligible for a premium tax credit, you could qualify for a special enrollment period and be able to sign up for coverage outside open enrollment.

What you should know about your options

• If you were previously ineligible for a premium tax credit but your income has recently changed, you should first check to see if you now qualify for a tax credit. If so, then you should probably purchase a Marketplace plan through Healthcare.gov.
• If you have not had a change in income, then you will not be able to purchase an individual major medical plan until open enrollment.
• If you are simply shopping for less expensive options, you might want to consider a short-term health plan. Short-term policies are not considered “minimum essential coverage” to avoid an individual mandate penalty, but they are considerably less expensive and often have lower cost sharing requirements than an individual health plan.
• If you have a side business and report the income or loss on your taxes, you may qualify for a small group health plan. Group policies are often less costly than individual health plans for comparable levels of coverage.
• If you do not own a small business, you might consider taking a college course and take advantage of the student health plans offered by many colleges and universities. Sometimes part-time students taking online courses are even eligible for a student plan.
• Though we wouldn’t necessarily recommend any of these options, there are some other solutions that you may want to consider. Limited benefit plans and supplemental products like critical illness policies and accident plans, while not comprehensive in nature, do provide some financial protection to help offset your medical costs. Similarly, joining a Health Care Sharing Ministry, while it is not insurance, does help pay some of your medical bills and also provides an exemption from the individual mandate penalty.