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How does the “new dependent” special enrollment period work?

When you have a baby – or when you adopt a child, a child is placed with you for adoption or foster care, or if you gain a dependent through a court order – you can qualify for a new dependent special enrollment period.  You and your dependents can enroll in coverage through the Marketplace.

The new dependent SEP lasts for 60 days from the date of the child’s birth (or adoption, court order, etc.).  New coverage generally will take effect retroactive to the date of birth (adoption, court order, etc.)

If you are already enrolled in Marketplace coverage through healthcare.gov, you can add your new dependent to your Marketplace plan or buy a different, separate policy for the child.  You cannot use the “new dependent” SEP to change health plans for already-covered family members.

This limitation on plan selection does not apply if you are an American Indian or Alaska Native.  In addition, if your current marketplace plan doesn’t cover dependents, you and your dependents can enroll together in a new plan at the same metal level as your current marketplace plan.

State-run Marketplaces have flexibility to expand special enrollment opportunities for consumers. Check with your State Marketplace for more information.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.