Missing the annual open enrollment window in Indiana does not mean you are stuck without health coverage for the rest of the year. If you have had a qualifying life event, such as losing job-based insurance, getting married, having a baby, or losing Healthy Indiana Plan (HIP) coverage after a redetermination, you can enroll in or change a Healthcare.gov marketplace plan during a Special Enrollment Period (SEP). Indiana uses the federal marketplace, so every SEP rule below applies whether you live in Indianapolis, Fort Wayne, Evansville, or a rural county. Most qualifying events give you 60 days from the event date to enroll, and one major 2026 rule change eliminated the year-round monthly SEP that low-income households used to rely on, so timing now matters more than ever.
What Is a Special Enrollment Period?
A Special Enrollment Period is a window outside the standard annual Open Enrollment Period when you are allowed to sign up for, or change, a marketplace health plan. Open Enrollment for 2026 coverage ran from November 1, 2025, through January 15, 2026. Outside that window, the only way to enroll is through an SEP triggered by a specific life change recognized by Healthcare.gov.
For most Indiana residents, the SEP window is 60 days. That clock generally starts on the date of the qualifying event, not the date you submit your application, so acting quickly matters. If you enroll within the first half of your 60-day window, coverage can often start the first day of the following month. Enroll later in the window and your start date may be pushed out further.
Qualifying Life Events That Trigger an Indiana SEP
Healthcare.gov groups qualifying events into four broad categories: loss of coverage, changes in household, changes in residence, and other special situations. Here is what applies in Indiana.
Loss of Health Coverage
- Losing job-based health insurance (layoff, reduced hours, employer drops coverage)
- Aging out of a parent's plan at 26
- Losing eligibility for the Healthy Indiana Plan (HIP) or Hoosier Healthwise because your income rose above the limit, or during an annual or (starting 2027) six-month redetermination
- Losing coverage through a former spouse after divorce
- Your individual market or COBRA plan ending
- Losing student health coverage after graduation
Changes in Household
- Getting married
- Getting divorced or legally separated and losing coverage as a result
- Having a baby, adopting a child, or placing a child for foster care
- A death in the family that changes household eligibility for a current plan
- Gaining a dependent through a child support order or court order
Changes in Residence
- Moving to Indiana from another state
- Moving within Indiana to a new county with different plan options
- A student moving to or from school in Indiana
- A seasonal worker moving into or out of the state
- Moving to or from a shelter or transitional housing
Other Qualifying Situations
- Gaining U.S. citizenship or lawfully present immigration status
- Leaving incarceration
- Becoming newly eligible for marketplace coverage because your income changed and you are no longer eligible for HIP or Hoosier Healthwise
- AmeriCorps members starting or ending service
- A serious medical condition, natural disaster, or other emergency that prevented you from enrolling during Open Enrollment (this exceptional circumstance SEP is reviewed case by case)
- Certain plan-level issues, such as your insurer violating its contract or a mapping error in your current plan
The Big 2026 Change: Low-Income Monthly SEP Is Gone
For several years, anyone with an estimated household income at or below 150% of the federal poverty level could enroll in a marketplace plan any month of the year, not just during Open Enrollment or a standard SEP. That monthly low-income SEP has been eliminated nationwide. A federal rule change first suspended it starting August 25, 2025, and the One Big Beautiful Bill Act plus a CMS rule finalized in 2026 made the elimination permanent for every state, including Indiana.
This matters differently in Indiana than it does in states that never expanded Medicaid. Indiana expanded Medicaid through the Healthy Indiana Plan (HIP 2.0), which covers non-disabled adults ages 19 to 64 with income up to about 138% of the federal poverty level, roughly $22,026 a year for a single adult in 2026. Because HIP already covers most low-income adults, the loss of the monthly marketplace SEP has less impact here than in non-expansion states. Where it does matter is the narrow income band just above HIP eligibility (roughly 138% to 150% FPL): those Hoosiers used to have year-round access to $0 or near-$0 premium marketplace plans, and now they generally have to wait for Open Enrollment or a qualifying event like losing HIP coverage to enroll.
If your income falls below 138% FPL, you likely qualify for HIP directly rather than needing marketplace coverage at all. See our Indiana benefits overview for the full picture of what you may qualify for.
2026 Federal Poverty Level Reference
| Household Size | 100% FPL (annual) | 138% FPL (HIP limit) | 150% FPL (annual) | 400% FPL (annual) |
|---|
| 1 | $15,960 | $22,025 | $23,940 | $63,840 |
| 2 | $21,640 | $29,870 | $32,460 | $86,560 |
| 3 | $27,320 | $37,702 | $40,980 | $109,280 |
| 4 | $33,000 | $45,540 | $49,500 | $132,000 |
These figures determine both your Healthy Indiana Plan eligibility and, if you are above the HIP limit, your premium tax credit amount for a marketplace plan enrolled through an SEP. Most Indiana marketplace enrollees between 138% and 400% FPL qualify for some level of premium subsidy.
How to Apply for an Indiana SEP
- Confirm your qualifying event and its date. Write down exactly when the event happened. This starts your 60-day clock.
- Gather documentation. Healthcare.gov typically asks for proof of the event: a termination letter or COBRA notice for lost coverage, a HIP or Hoosier Healthwise denial or termination notice, a marriage certificate, a birth certificate or adoption paperwork, or a signed lease or utility bill for a move.
- Go to Healthcare.gov. Indiana does not run its own state exchange, so all applications go through the federal marketplace at Healthcare.gov or by calling 1-800-318-2596.
- Report your household income and size. This determines whether you qualify for HIP, a marketplace plan with subsidies, or both. Be as accurate as possible since income is reconciled at tax time.
- Select your event and upload documents. The system will prompt you to describe your qualifying event and attach proof, usually within 30 days of starting your application.
- Choose a plan. Five carriers sell 2026 individual marketplace plans in Indiana: Anthem, CareSource, Cigna, Ambetter (Coordinated Care), and UnitedHealthcare. Compare plans by monthly premium, deductible, and provider network. Most Indiana marketplace plans are HMO or EPO networks, so check that your doctors are in-network before enrolling.
- Pay your first premium. Coverage does not start until you pay, even after your application is approved.
- Get a confirmation of your coverage start date. This depends on when in your 60-day window you enrolled.
You can also work with a licensed insurance agent or a certified navigator at no extra cost. Indiana has CMS-certified navigator organizations, including those funded through the state's Department of Insurance, that can help you gather documents and complete the application in person or by phone.
SEP Coverage Start Dates
| When You Enroll | Typical Coverage Start Date |
|---|
| 1st through 15th of the month | 1st of the following month |
| 16th through end of month | 1st of the second following month |
| Birth, adoption, foster placement | Date of the event (retroactive) |
| Marriage | 1st of the month following plan selection |
Birth and adoption are treated differently than most events. Coverage can start on the actual date of birth or adoption, even if you enroll a few weeks later, as long as you are within the 60-day window.
What Happens If You Miss the 60-Day Window
If you do not act within 60 days of a qualifying event, that SEP opportunity closes. You would then need to wait for the next annual Open Enrollment Period, unless a new qualifying event occurs in the meantime. There is no general "hardship" extension outside the narrow exceptional circumstances category, so it pays to apply as soon as possible after a life change.
Indiana-Specific Notes
Indiana residents use Healthcare.gov exclusively since the state has not built its own exchange. Unlike many states, Indiana updates its Medicaid and HIP income limits each year on March 1, not January 1, so the numbers that apply to your application can shift partway through the year depending on when you apply. Indiana expanded Medicaid in 2015 through HIP 2.0, and that expansion is approved through December 31, 2030, which means far fewer working-age Hoosiers fall into a coverage gap than in the twelve states that never expanded Medicaid. That said, changes are coming: starting January 1, 2027, most HIP members ages 19 to 64 will need to complete 80 hours a month of work, school, job training, or community service to keep coverage, and eligibility redeterminations will move from annual to every six months. Losing HIP coverage for any of these reasons, including a missed redetermination, triggers a 60-day marketplace SEP. If your household situation changed and you are unsure whether you qualify for an SEP, HIP, or another assistance program, a free eligibility screening can walk through your specific circumstances in a few minutes.
Frequently Asked Questions
How long is the Indiana Special Enrollment Period?
Most qualifying events give you 60 days from the date of the event to enroll in a marketplace plan through Healthcare.gov. Some events, like losing coverage, also allow you to apply up to 60 days before the loss actually occurs.
Does Indiana still have a low-income SEP for people under 150% FPL?
No. The monthly special enrollment period for households at or below 150% of the federal poverty level was eliminated nationwide starting in late 2025 and made permanent through federal rulemaking in 2026. This includes Indiana. Households in that income range must now enroll during the standard Open Enrollment Period or through a separate qualifying event, such as losing HIP eligibility.
Can I get an SEP just because my income dropped?
Generally, only if the income change causes you to gain new eligibility for premium tax credits, or if it causes you to lose eligibility for the Healthy Indiana Plan. A drop in income by itself, without a change in program eligibility, is usually not treated as a standalone qualifying event.
What documents do I need for an Indiana SEP application?
It depends on the event. Common documents include a job termination letter, COBRA election or termination notice, marriage certificate, divorce decree, birth or adoption certificate, a new Indiana lease or utility bill, or a HIP or Hoosier Healthwise denial or termination notice.
Can I switch plans during an SEP or only enroll for the first time?
If you already have marketplace coverage and experience a qualifying event, you can typically switch to a different plan within the same or a different metal tier, not just enroll for the first time.
What if I lose Healthy Indiana Plan coverage?
Losing HIP coverage, whether from an income increase, a missed redetermination, or (starting in 2027) a missed work requirement, triggers a 60-day marketplace SEP. If your income is still under 138% FPL, you should also try to re-establish HIP eligibility rather than pay for a marketplace plan.
Does moving within Indiana count as a qualifying event?
Yes, if the move gives you access to new plan options, such as moving to a county served by different insurers. A move within the same service area with no new plan options generally does not qualify.
When is the next Open Enrollment Period for Indiana?
The next annual Open Enrollment Period is expected to run from November 1, 2026, through January 15, 2027, for coverage effective in 2027. Exact dates are confirmed by CMS closer to the fall.
