Qualifying Life Events

A qualifying event is a life change that opens a door to health coverage you could not otherwise get at that moment. Two separate systems use the term, and they do not mean the same thing.
COBRA qualifying events are the specific events that give you the right to stay on an employer plan. Marketplace qualifying life events are the changes that open a Special Enrollment Period to buy an individual plan outside of Open Enrollment. Losing a job triggers both. Getting married triggers only the second. This page covers each in turn.

Reviewed and updated 1 August 2026 against current federal guidance.

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COBRA Qualifying Events

The event determines two things: who is entitled to continue coverage, and for how long. An event only counts if it actually causes a loss of coverage under the plan.
Qualifying eventWho may continueMaximum period
Job loss, for any reason other than gross misconductEmployee, spouse, dependent children18 months
Reduction in the employee’s hoursEmployee, spouse, dependent children18 months
Divorce or legal separationSpouse, dependent children36 months
Death of the covered employeeSpouse, dependent children36 months
A child loses dependent status under the planThat dependent child36 months
The employee enrolls in MedicareSpouse, dependent children36 months
Job loss counts whether you quit, were laid off, or were let go. Gross misconduct is the single exception.

A Note on Medicare

Medicare is the most misunderstood item on that list. An employee enrolling in Medicare while still working does not usually lose group coverage, so there is usually no qualifying event at all. Where it matters is for the family: if the employee’s Medicare enrollment causes a spouse or child to lose coverage, those dependents may continue for up to 36 months.
Becoming eligible for Medicare is also not the same as being entitled to it. The rules turn on actual entitlement, and how they apply depends on the timing relative to the job ending.

Who Has to Tell the Plan, and By When

This is where people most often lose rights they were entitled to. For some events the employer notifies the plan. For others the responsibility is yours, and the deadline is short.
EventWho notifies the planDeadline
Job loss or reduction in hoursYour employer30 days
Death of the covered employeeYour employer30 days
Employer bankruptcyYour employer30 days
Divorce or legal separationYou60 days
A child losing dependent statusYou60 days

If you are divorcing, this deadline is yours to meet

Nobody else will report a divorce or legal separation to the health plan. If the 60-day window passes without notice, the right to continue coverage can be lost. A court decree of divorce or legal separation is required. Filing paperwork or beginning the process is not enough on its own.
Once the plan knows, it must send an election notice within 44 days of the qualifying event, or within 14 days of being notified by you.

When 18 Months Can Become More

Disability extension. If the Social Security Administration determines that a qualified beneficiary is disabled before the 60th day of COBRA coverage, and the disability continues through the initial 18-month period, all qualified beneficiaries may receive an additional 11 months, for up to 29 months in total. The plan may charge up to 150 percent of the premium during the extension.
Second qualifying event. If a second event happens during the initial 18 months, such as a divorce or the death of the covered employee, coverage may extend by a further 18 months, up to 36 months in total. The same 60-day notice rule applies for divorce, legal separation, or a child losing dependent status.

What Does Not Qualify

• Taking FMLA leave. Your employer must maintain your coverage during the leave, so nothing is lost. If you do not return afterwards and coverage ends then, that can be a qualifying event.
• Losing coverage because premiums went unpaid. Voluntary or non-payment loss does not open a Marketplace Special Enrollment Period.
• Dropping coverage by choice. Choosing to end coverage you could have kept is not the same as losing it.
• A divorce that does not cost anyone their coverage. For Marketplace purposes, divorce alone is generally not enough. The loss of coverage is what counts.
• Working for an employer COBRA does not cover. Federal government employees are covered by a separate law, and church plans are generally exempt.

Marketplace Qualifying Life Events

These open a Special Enrollment Period to buy an individual or family plan. The window is generally 60 days, and for some events you can enroll in the 60 days before the change as well as after.
Life eventWindow to enrollNotes
Losing job-based, individual, or student coverage60 daysIncludes COBRA running out. Losing coverage for non-payment does not count
Losing Medicaid or CHIP90 daysA longer window than other coverage losses
An employer or government COBRA subsidy ending60 daysYou may move to a Marketplace plan when the subsidy stops
Turning 26 and aging off a parent’s plan60 daysCoverage may run to the end of the month or plan year
Getting married60 daysCoverage can begin the first day of the following month
Having a baby, adopting, or fostering60 daysCoverage can be backdated to the date of the event
Moving to a new area with different plans60 daysYou generally must have had coverage before the move
Divorce or legal separation that costs you coverage60 daysThe loss of coverage is what triggers it, not the divorce itself
You may be asked to send documents proving the event before coverage can begin.

One event, two doors, one clock

Losing job-based coverage opens both options at once, and both run on roughly the same 60-day timeline. That is the moment to compare them, because electing COBRA and then dropping it voluntarily does not reopen the Marketplace window. Letting COBRA run out completely does.
Compare COBRA and Marketplace coverage →
What to do when you lose coverage →
Read the full COBRA explainer →

Sources

The information on this page is drawn from the following federal sources. Your own plan documents govern your specific situation.

Not sure which event applies to you?

A licensed agent can confirm which door is open, how long you have, and what each option would cost. No charge, no obligation.
Get My Options
This page is general information, not advice about your specific situation. Your plan documents and the Marketplace determine what applies to you. A licensed agent can review your circumstances with you.

Prefer to talk? Call (888) 918-4516 · Monday to Friday, 10:00 a.m. to 5:30 p.m. Eastern

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