During a special enrollment period, who is eligible to enroll in or change their health plans?

The correct answer is that individuals newly eligible due to specific qualifying events can enroll in or change their health plans during a special enrollment period. Under the Affordable Care Act (ACA), special enrollment periods are designed to allow certain individuals who experience specific life events, such as getting married, having a baby, or losing other health coverage, to make changes to their health insurance.

These qualifying events trigger the opportunity for enrollment outside of the regular open enrollment period. Being newly eligible means that the person’s circumstances have changed in a way that necessitates or allows for a new health insurance choice.

In contrast, individuals with pre-existing conditions may have a wide array of options available to them, but their condition alone does not trigger eligibility for special enrollment; it is the specific qualifying life event that does. The ability to enroll during a special enrollment period does not apply to all individuals universally, as it is restricted to those who meet these criteria. Lastly, while missed previous enrollment opportunities can be frustrating, they do not qualify an individual for a special enrollment period unless accompanied by a specific qualifying event.