Missing the annual Open Enrollment window in Michigan 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, having your insurer pull out of the market, getting married, having a baby, or losing Healthy Michigan Plan coverage, you can enroll in or switch a Healthcare.gov marketplace plan during a Special Enrollment Period (SEP). Michigan uses the federal marketplace, so the SEP rules below apply whether you live in Detroit, Grand Rapids, Lansing, Ann Arbor, Traverse City, or anywhere in the Upper Peninsula. 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 some low-income households used to rely on. Because Michigan expanded Medicaid, that change hits Michigan households differently than it hits residents of states that never expanded.
What Is a Special Enrollment Period?
A Special Enrollment Period is a window outside the standard annual Open Enrollment Period when you can sign up for, or make changes to, 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 in Michigan is through an SEP triggered by a qualifying event recognized by Healthcare.gov.
For most Michigan 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 it pays to act quickly. 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 a Michigan 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 Michigan.
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 Michigan Plan (Michigan's expanded Medicaid program) or MIChild, the state's CHIP program for kids
- Your insurer leaving the Michigan marketplace or discontinuing your plan
- 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 Michigan from another state
- Moving within Michigan to a new county with different plan options
- A student moving to or from school in Michigan
- A seasonal or agricultural 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 rose above the Healthy Michigan Plan limit
- Members of federally recognized tribes, who can enroll or change plans year-round without a standard qualifying event
- 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
Carrier Exits Are a Michigan-Specific SEP Trigger This Year
Michigan's individual market shrank sharply for 2026. The number of carriers offering plans on Healthcare.gov in Michigan dropped from roughly ten in 2025 to about seven for 2026, with remaining options including Blue Cross Blue Shield of Michigan, Blue Care Network, Priority Health, Meridian, McLaren Health Plan, and others depending on county. Over 200,000 Michigan residents were estimated to be affected by a carrier leaving the marketplace or shrinking its service area.
If your plan was discontinued or your insurer left your county, that is a loss of coverage and it opens a Special Enrollment Period. The same is true if a carrier exits mid-year. You generally get 60 days from the date your coverage ends, and you can also apply up to 60 days before the termination date so there is no gap. Do not wait for the last day. Michigan premiums rose steeply for 2026 as well, with approved increases in the roughly 19% to 26% range for major carriers, which makes it worth comparing plans rather than accepting whatever replacement plan you were mapped into.
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, and federal law extended the change beyond a single plan year, so it is not scheduled to return.
This change lands differently in Michigan than it does in states that never expanded Medicaid. Michigan expanded Medicaid through the Healthy Michigan Plan, which covers adults ages 19 to 64 with income up to roughly 138% of the federal poverty level, about $1,732 a month for a single person, with no asset test. Because that Medicaid coverage is available year-round with no enrollment deadline, most low-income Michigan adults below 138% FPL already have a coverage path that does not depend on marketplace SEP rules at all.
Where the change still matters in Michigan is the narrow band between about 138% and 150% FPL. Adults in that income range earn too much for the Healthy Michigan Plan but previously could use the monthly low-income marketplace SEP if they missed Open Enrollment. Now, without a separate qualifying event, that group has to wait for the next annual Open Enrollment Period like everyone else. If your income is under 138% FPL, your first stop should be applying for the Healthy Michigan Plan through MI Bridges at newmibridges.michigan.gov, not a marketplace SEP, since Medicaid applications are accepted any time of year. See our Michigan benefits overview for details on applying for the Healthy Michigan Plan and MIChild.
Medicaid Work Requirements Will Create New SEPs in 2027
Federal legislation requires Michigan to apply community engagement requirements to most Healthy Michigan Plan enrollees ages 19 to 64. Under the rules announced by MDHHS, affected enrollees must document a qualifying activity, generally work, job training, education, or community service, each month to keep coverage. The requirements take effect January 1, 2027, and the first group required to submit proof will be those due for renewal in March 2027. Roughly 700,000 Michiganders are enrolled through the Healthy Michigan Plan.
This matters for SEP planning. Losing Healthy Michigan Plan coverage, including for failure to meet the new documentation rules, is a qualifying event that opens a 60-day Special Enrollment Period on Healthcare.gov. If you get a termination notice from MDHHS, do two things at once: appeal or correct your Medicaid paperwork if you believe the termination is wrong, and start a marketplace application so you do not run out the 60-day clock while the appeal is pending. Exemptions from the new requirements are expected for people who are medically frail, pregnant or postpartum, in foster care, certain caregivers, disabled veterans, people in substance use disorder treatment, and people recently released from incarceration.
MIChild and Medicaid for Kids Run Separately From SEP Rules
Michigan's CHIP program, MIChild, covers children up to age 19 in families with income above the Medicaid limit and generally up to about 217% FPL, with a premium of roughly $10 per family per month. Like the Healthy Michigan Plan, MIChild accepts applications year-round through MI Bridges and does not require a marketplace-style SEP or Open Enrollment window. If your child loses other coverage or your household income changes, apply through MI Bridges as soon as possible rather than waiting for a marketplace enrollment period.
2026 Federal Poverty Level Reference
| Household Size | 100% FPL (annual) | 138% FPL (annual) | 150% FPL (annual) | 400% FPL (annual) |
|---|
| 1 | $15,960 | $22,025 | $23,940 | $63,840 |
| 2 | $21,640 | $29,863 | $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 Michigan Plan eligibility (up to roughly 138% FPL) and your premium tax credit amount if you enroll in a marketplace plan through an SEP. Most Michigan residents between 138% and 400% FPL qualify for some level of premium subsidy. With the enhanced subsidies that applied through 2025 no longer in place for 2026, the amount you pay after tax credits is higher than it was last year, and households above 400% FPL face the full unsubsidized premium.
How to Apply for a Michigan 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 carrier discontinuation notice, a marriage certificate, a birth certificate or adoption paperwork, a signed lease or utility bill for a move, or an MDHHS notice showing loss of Healthy Michigan Plan or MIChild coverage.
- Go to Healthcare.gov. Michigan 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 both your premium tax credit eligibility and whether you should be routed to the Healthy Michigan Plan instead of a marketplace plan.
- Select your event and upload documents. For 2026, the federal marketplace verifies SEP eligibility before coverage begins for many event types, so expect to submit proof, usually within 30 days of starting your application.
- Choose a plan. Compare available Bronze, Silver, and Gold plans by monthly premium, deductible, and provider network. Networks changed significantly in Michigan for 2026, so confirm your doctors and hospital are in network before selecting. Silver plans are the only tier eligible for cost-sharing reductions if your income qualifies.
- 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. Michigan has CMS-certified navigator organizations that help residents gather documents and complete applications in person or by phone, and you can find one near you through localhelp.healthcare.gov. MDHHS caseworkers, reachable at 1-844-799-9876, can help determine whether you belong on the Healthy Michigan Plan, MIChild, or a marketplace plan.
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 |
| Loss of coverage, applied in advance | 1st of the month after prior coverage ends |
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. If your income is low enough, remember that the Healthy Michigan Plan and MIChild both accept applications year-round through MI Bridges, so a missed marketplace SEP does not necessarily mean a coverage gap.
Michigan-Specific Notes
Michigan residents use Healthcare.gov exclusively since the state has not built its own exchange. The Michigan Department of Insurance and Financial Services (DIFS) does not process marketplace applications, but it reviews and approves the rates and plan filings of the insurers who sell on the exchange, and it runs a consumer hotline for coverage complaints and appeals. Because Michigan expanded Medicaid through the Healthy Michigan Plan, working adults with low incomes have a year-round coverage path that does not depend on marketplace enrollment timing, which is the opposite of what happens in non-expansion states where marketplace SEPs are often the only route to coverage. The two things most likely to open an SEP for a Michigan household this year are a carrier exit that ended your plan and a change in Healthy Michigan Plan eligibility. If your household situation changed and you are unsure whether you qualify for a marketplace SEP, the Healthy Michigan Plan, MIChild, 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 Michigan 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, which is the best way to avoid a gap.
Does my insurer leaving Michigan count as a qualifying event?
Yes. If your carrier exited the Michigan marketplace or discontinued your plan, that is treated as a loss of coverage and opens a 60-day Special Enrollment Period. More than 200,000 Michigan residents were affected by carrier exits and service area reductions heading into 2026.
Does Michigan 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. In Michigan, most adults below 138% FPL already qualify for the Healthy Michigan Plan year-round, so this change mainly affects the narrow band between 138% and 150% FPL, who now have to enroll during standard Open Enrollment or through a separate qualifying event.
What happens to my coverage options if I lose the Healthy Michigan Plan?
Losing Healthy Michigan Plan eligibility is a qualifying event. You get 60 days from the date coverage ends to enroll in a marketplace plan through Healthcare.gov, and depending on your income you may qualify for premium tax credits. New federal work and community engagement documentation rules take effect January 1, 2027, so this route is likely to matter for many Michigan households next year.
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 Michigan Plan or MIChild. 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 a Michigan SEP application?
It depends on the event. Common documents include a job termination letter, COBRA election or termination notice, a plan discontinuation letter from your insurer, a marriage certificate, a divorce decree, a birth or adoption certificate, a new Michigan lease or utility bill, or an MDHHS notice showing loss of Medicaid or MIChild coverage.
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.
Does moving within Michigan count as a qualifying event?
Yes, if the move gives you access to new plan options, such as moving from a rural county to a metro 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 Michigan?
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.
