If you got a notice that your ACA coverage is ending, or your premium shot up and no longer fits your budget, do not wait. You may still have options, but the window to act is limited.

What Changed in 2026

For the past few years, enhanced federal subsidies helped keep ACA Marketplace premiums lower for many Americans. Those subsidies expired at the end of 2025, which left a lot of people facing higher monthly costs in 2026. For a broader look at how health coverage works, see our Insurance and Risk Management guide.

That does not mean you did anything wrong. It usually means the numbers changed, and now you need to look at your coverage again with fresh eyes.

Your 60-Day Window

Losing health coverage is a qualifying life event under the ACA. That gives you a Special Enrollment Period, which lets you enroll within 60 days before or after the event. According to HealthCare.gov, you can also start the process up to 60 days before your coverage ends if you have advance notice.

If you miss that window, your next chance to enroll in most Marketplace plans is during Open Enrollment, which begins November 1, 2026. Going uninsured until January is a risk most families cannot afford. One emergency room visit without coverage can run $3,000 to $30,000.

What You Need to Show

HealthCare.gov requires proof of your coverage loss when you qualify for a Special Enrollment Period. You usually have 30 days to confirm eligibility after you select a plan. Acceptable documents include a termination letter from your insurer, a notice showing Medicaid or CHIP ended, or an employer notice that your coverage is ending. Do not wait on this. Missing the document deadline means your new coverage never activates.

Your Main Options

1. A new ACA Marketplace plan. Start here if you lost ACA coverage. Go to HealthCare.gov or your state Marketplace, enter your income and household size, and review the plans you qualify for. You may still be eligible for premium tax credits even without the enhanced subsidies. A free local navigator can help at localhelp.healthcare.gov.

2. Medicaid or CHIP. If your income dropped, you may qualify now even if you did not qualify before. Medicaid does not have the same enrollment window as Marketplace plans, so you can apply any time of year. Check your state eligibility at Medicaid.gov.

3. COBRA continuation coverage. If you lost employer coverage, COBRA may let you stay on the same plan for up to 18 months. You pay the full premium plus a 2% administrative fee, so it can be expensive. If you are in treatment or need to keep the same doctors, it may buy you time while you sort out a longer-term option.

4. Employer coverage from a new job. If a new job is coming up soon, ask when your health coverage starts. Many employers have a waiting period of 30 to 90 days. A Marketplace plan or other temporary option may help bridge that gap. For more on how coverage types compare, see our health insurance guides.

What Not to Do

Do not assume you can wait and figure it out later. Do not use a short-term health plan as a replacement for ACA coverage. It is not ACA-compliant and usually does not cover pre-existing conditions. And do not let the 60-day window pass while you are still deciding. The fastest move is to check your options now and ask for help if you need it.

The Steps, In Order

1. Find your coverage termination letter or any notice showing your coverage ended.
2. Go to HealthCare.gov and start a Special Enrollment Period application. Select “I lost or will soon lose my health coverage” as your qualifying event.
3. Enter your income, household size, and zip code to see what you qualify for.
4. Review your plan options and choose the one that fits your budget and your care needs.
5. Upload or submit your documents within the required deadline.
6. If you need help, use localhelp.healthcare.gov or contact your state insurance commissioner through NAIC.org.

Frequently Asked Questions

What if I already missed my 60-day Special Enrollment window?

Your next option is Open Enrollment, which begins November 1, 2026. But do not wait to check Medicaid. Medicaid has no enrollment window, and you can apply any time of year if your income qualifies. Go to Medicaid.gov or contact your state Medicaid office to find out where you stand now.

Do I still qualify for subsidies now that the enhanced subsidies are gone?

The standard premium tax credit from the original ACA is still in place. If your income falls between 100% and 400% of the federal poverty level, you likely qualify for some level of help. Enter your current income into HealthCare.gov before you assume you do not qualify. Many people are surprised by what they are eligible for once they run the actual numbers.

How soon does new ACA coverage start after I enroll?

Coverage through a Special Enrollment Period typically starts the first day of the month after you select a plan and make your first payment. Some situations allow an earlier start date. Confirm your effective date before you let any current coverage lapse, especially if you have prescriptions or upcoming appointments.

Is COBRA worth paying for when a Marketplace plan is available?

For most people, a Marketplace plan with subsidies costs far less than COBRA. COBRA requires you to pay the full premium, both what you paid before and what your employer covered, plus a 2% fee. The main reason to choose COBRA is continuity of care, staying with the same doctors or coverage while mid-treatment. Compare both options against what you actually need before you decide.

The Bottom Line

Losing ACA coverage is stressful, but it is not the end of the road. The key is to act inside your window, check what you qualify for now with your current income, and choose a plan based on what you actually need. If the process feels confusing, a free navigator can walk you through it step by step at no cost.