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We'll look at direct primary care options in your area and contact you with your estimate.
Prefer to talk now? Call (743) 223-5388The short answer
If it isn't January 15, 2027 yet, you haven't missed it: open enrollment for 2027 plans is still open on HealthCare.gov, and a plan picked after December 15 starts February 1. After January 15, you can only buy a Marketplace plan if a life event opens a special enrollment period. Some options, like health sharing and direct primary care, don't need open enrollment at all.
Then go through the four steps below. Most people can do it in an afternoon.
| Your situation | Look at this first |
|---|---|
| Lost a job-based plan in the last 60 days | Special enrollment period on HealthCare.gov, and compare with COBRA |
| Moved, married, had or adopted a baby | Special enrollment period (usually 60 days) |
| Lost Medicaid or a kids' program | Special enrollment period (often 90 days) |
| Income is low | NC Medicaid (any month) |
| No life event, healthy, need something now | Options you can start any month (step 4) |
| Ongoing condition, no life event | NC Medicaid if eligible; otherwise plan for the next open enrollment, and ask a licensed agent what's possible |
Step 1: Check for a special enrollment period
A special enrollment period lets you buy a Marketplace plan outside open enrollment after certain life events. You usually have 60 days from the event (source). The most common ones:
- Losing other health coverage, such as a job-based plan, a parent's plan at 26, or COBRA running out. You can often apply up to 60 days before the coverage ends, so there's no gap.
- Losing Medicaid or a children's program. This window is often 90 days.
- Moving to a new county or state, in most cases if you had coverage before the move.
- Household changes: getting married, having a baby, adopting, or a divorce that ends your coverage.
Some things don't count: dropping a plan on purpose, losing a plan because you stopped paying, or losing something that isn't qualifying health coverage, like health sharing or most short-term plans. You may need to show proof, such as a letter from your old employer.
Step 2: Check NC Medicaid
NC Medicaid takes applications in any month; there's no open enrollment. North Carolina expanded Medicaid in December 2023, so many adults with low incomes qualify. From January 1, 2027, most expansion adults ages 19 to 64 must show 80 hours a month of work, school, training or community service, unless exempt (source).
Step 3: If you lost a job-based plan, compare COBRA
COBRA lets you keep your old employer's plan, usually for up to 18 months. The catch is the price: you can be charged the full cost of the plan, the part your employer used to pay plus your part, plus 2% (source). You usually have 60 days to choose COBRA and 45 days after that to make the first payment, and it can start back on the day your old plan ended.
Losing your job's plan also opens a special enrollment period, so you can compare COBRA with a Marketplace plan and a possible tax credit. Dropping COBRA on purpose outside open enrollment usually doesn't open a new window, but COBRA running out does.
Step 4: Options you can start any month
If no life event applies, Marketplace plans wait until the next open enrollment. These don't:
- Health sharing can start on the first of any month. It's not insurance: members share large medical bills under the sharing guidelines, pre-existing conditions have waiting periods, and sharing is not guaranteed.
- Direct primary care gives you a doctor's team for everyday care for a flat monthly fee, starting any time.
- Dental and vision savings plans give discounts at participating providers, from any month.
- Short-term health insurance is insurance with limits. North Carolina keeps the federal limit: up to 3 months, and 4 months in total with renewals (source). It can turn you down or exclude conditions. We don't sell it; see how it compares with health sharing.
When to contact HealthCare.gov or a licensed agent
Reach out if someone in your house has an ongoing condition, is pregnant, or needs regular care that an alternative won't pay for. Those are the cases where waiting for a Marketplace plan, or finding a special enrollment period, matters most. We'll tell you the same if you call us.
Mark your calendar
Open enrollment for 2028 plans is expected to start around November 1, 2027. Watch HealthCare.gov for the dates. See open enrollment 2027 in Greensboro.
Common questions
Can I still get a health plan after open enrollment ends?
Only if a life event in the last 60 days, such as losing other coverage, moving or having a baby, opens a special enrollment period. Otherwise you wait for the next open enrollment on HealthCare.gov.
Is COBRA my only option after losing my job?
No. Losing job-based coverage also opens a special enrollment period, usually for 60 days, so compare COBRA with a Marketplace plan.
Does low income alone let me enroll?
Usually not. But NC Medicaid takes applications in any month, so check whether you or your children qualify.
What can I start any month?
Health sharing (from the first of any month), direct primary care, and dental and vision savings plans. None of them is insurance, and health sharing has limits for pre-existing conditions.
Sources
- HealthCare.gov: special enrollment periods and qualifying life events
- Understanding COBRA continuation coverage: length, 102% cost limit, 60-day election (CMS Marketplace job aid)
- What federal Medicaid changes mean in NC: work requirements from Jan 1, 2027, 80 hours a month, about 255,000 at risk (WFAE, Jan 17, 2026)
- NCDOI Bulletin 25-B-11: short-term limited duration health insurance (Aug 29, 2025)
Missed the deadline and need something now?
Tell us who needs care. We'll walk you through what you can start this month, and tell you if a special enrollment period or the Marketplace is the better fit.
Free, no obligation. Greensboro, Winston-Salem, High Point and Triad households.