If you have a “qualifying event,” you may have a couple of special enrollment opportunities.

Examples of qualifying life events include:

• Marriage
• Birth
• Adoption

What you should know about your options:

• If you get married, have a child, or adopt a child, you have a special enrollment opportunity under HIPAA. This allows you to sign your spouse or new child up on the group health coverage through your employer or sign up for coverage under your spouse’s employer-sponsored health plan. In Texas, you have 30 to 31 days after the qualifying event to do this.
• Similarly, you have the opportunity to sign up for coverage in the individual market, either through the Marketplace (Healthcare.gov) or outside the Marketplace (off exchange). You have 60 days from the date of the qualifying event to purchase an individual policy.
• Usually, employer-sponsored coverage, if it’s available, will be the better option. Plans are often more comprehensive and may provide a broader network of providers than is available in the individual market. Additionally, group health premiums are often lower than individual health premiums, and the employer might be contributing to the cost of your coverage.
• If you do not have employer coverage available to you, you should consider an individual health plan. It is possible that the addition of a family member (a new spouse or a new child) could help you qualify for a premium tax credit if your income does not change as a result. Alternatively, adding a new spouse’s income to your income could disqualify you from a premium tax credit if you are already receiving financial assistance. If you are, you will need to notify the Marketplace about your change in status.
• If you have a small business (as a sole proprietor) and you get married, it’s possible you will qualify for group health coverage after you file your first federal income tax return. Joint filers who file a Schedule C with their tax return are considered co-owners of the business and therefore qualify for a small group plan.