Can You Change Your Health Insurance Plan After Open Enrollment?

Enrolling on a health insurance plan is a great way to ensure you have peace of mind. The coverage allows you to visit a specialist, get routine checkups, fill prescriptions or take care of any other serious health issues.

However, to get a plan that adheres to the Affordable Care Act standards, you will need to enrol or change during the annual open enrollment. The period runs between November 1 and December 15 in most states.

But can you change your health insurance plan after open enrollment? The simple answer is yes, but under special circumstances.
This post looks at how and when you can change your health insurance plan after open enrollment.

An Overview of Open Enrollment

In the past, insurance health companies could reject coverage or refuse insurance premiums to a person depending on their medical history. For this reason, the ACA prohibited insurance companies from denying coverage to an individual due to any pre-existing condition or reason.

But ACA also wanted to avoid the situation where individuals went for health insurance the month they realize they require medical care. Therefore, it established an open enrollment period where everyone can receive health insurance once a year.

However, it also specified qualifying events with which a person can change health insurance plans after open enrollment. A qualifying event is a substantial change in life that allows you to change your health insurance plan outside an open enrollment period.

Different types of Qualifying Life Events

● Change of Family Structure
If you get married, add a child to your household, or a child moves out, then you can change your insurance plan after open enrollment.

● Change of Citizenship Status
You are eligible to change your health insurance if you recently became a U.S. citizen or were recently released from incarceration.

● Change of Income
If you get a higher income, you may be no longer eligible for premium-free Medicare Part A or Medicaid. Similarly, in case of a decrease in your earning and you become eligible for Medicaid, you can change your health insurance after open enrollment.

● Lost Coverage through a Family Member
This applies if the health insurance policy you had was through a family member’s policy but lost due to divorce, death, or no longer being dependent. In that case, you qualify to change outside the open enrollment under this category. It also applies if a family member lost the coverage, say, due to a change of income and caused you to lose it as well.

● Lost Job-based Coverage
You can change your health insurance plan outside open enrollment if you voluntarily reduced your work hours or left your job. Besides, it also applies if your job-based coverage does not adhere to the current standards for affordability and value.

● Lost Coverage through an Individual Plan
Some circumstances, such as relocating or no longer being a student, may result in loss of coverage. In such a case, you can change your health insurance outside the open enrollment. However, you won’t be eligible under this category if you gave up on paperwork, stopped paying premiums or willingly pulled out from your individual plan.

Bottom Line

The bottom line is that you might not have to wait for the government or your employer’s next open enrollment period to change your health insurance plan. If you have experienced any of the above events, you can enrol or change your plan.

At Healthcare Solutions Team, we commit to reaching anyone who needs multiple insurance offerings, including life, health, Medicare supplemental, dental and group plans. We provide customized insurance policies that maximize coverage while minimizing cost. Reach out to us today for all your health insurance needs.

Healthcare Solutions Team is a wholly-owned subsidiary of the National General Insurance Group and Allstate Insurance Company.