When life changes, it makes the future uncertain. These days, the future of health insurance is not very certain. Every year during annual enrollment, you can make desired changes to your health insurance or buy a new one if you are not already insured. Now, this is common knowledge. Let’s tell you something about health insurance that you do not already know.
Usually, everybody awaits the Annual Enrolment season to get a health insurance plan not knowing that you can apply for health insurance throughout the year if you face a Qualifying Life Event. Now, you may be assuming what’s a Qualifying Life Event. So, Let’s remove the complexities from this term and make it more comprehensible.
A Qualifying Life Event means any change in your life that enables you to buy a health insurance policy at any time of the year. It basically provides you with a special enrollment period. If you get married, have a baby, go through a divorce, adopt a child, move to another county, lose your dependent status, change your immigration status or get an increase/decrease on your income, you can be eligible to modify your existing health insurance or buy a new one altogether even if the open enrollment season had ended.
Now, you may not be sure whether you qualify for the special enrollment plan or not. Let’s apprise you of how the special enrollment period works and whether or not you are eligible to get a health insurance policy through it.
How Special Enrollment Period Works?
Normally, you are given a period of two months to make necessary changes to your health insurance plan after you have a Qualifying Life Event. Your Health Insurance provider should be contacted immediately after you face such an event. Once your Health Insurance provider is notified, the special enrollment process kicks off. However, before the process is initiated, you are asked for evidence to corroborate your eligibility. For example, if you have lost your dependent status, you’ll have to provide a court letter substantiating that. You may be asked for a Denial Letter if you have been denied coverage by Children’s Health Insurance Program (CHIP) or Medicaid.
Typically, you will be given a month to provide evidence that substantiates that you are entitled to a special enrollment plan. You’ll be constantly updated about the status of your special enrollment plan and any outstanding requirements.
It must be noted that if you apply for the Special Enrollment Period plan after 60 days, you will lose your chance to avail this plan and will have to wait for the next open season.
What Events Are Categorized as Qualifying Life Events?
Following events are categorized as Qualifying Life Events that enable you to avail a Special Enrollment Period plan:
- If you get married, you are eligible for a special enrollment period plan. If you get hitched, you should elect a plan by the last day of the month so that your coverage gets active on time. On the other hand, you can have your coverage started from the day the event takes place regardless of what plan you opt for if you adopt a baby, have a baby, or foster out your child. Divorce and Legal Separations do not grant you the eligibility for Special Enrollment Period if you don’t lose your coverage.
- Having and adopting a baby also makes you entitled to a Special Enrollment Period Plan. Same goes for fostering a child.
- If you move to a new state or get, you have a right to get insurance through special enrollment period programs.
- If you are an immigrant, you can get eligibility for a special enrollment period plan.
- In case you pursue a medical treatment somewhere other than your residential county, you are not entitled to a Special Enrollment Period plan.
Loss of Health Insurance
If you or anyone in your family loses their health coverage, you may be entitled to a Special Enrollment Period plan if you apply for one within the next 60 days. Loss of Coverage requires evidence and you may have to substantiate your eligibility by submitting relevant documents.
Following are the coverage losses that make you eligible for a Special Enrollment Period:
- Losing an individual Health Insurance plan that you purchased yourself
- Losing a Health Coverage bought by your employer
- Losing Eligibility for Children’s Health Insurance Program (CHIP)
- Losing Eligibility for Medicaid
- Losing Eligibility for Medicare
Non-Qualifying Life Events
There are many events that seem like qualifying events but are not. These are usually some life-changing circumstances that affect your health insurance but do not grant eligibility for a Special Enrollment Period. These may include dropping your health insurance voluntarily, insurance termination due to premium defaults etc.
If you did not sign up for a health insurance plan during the annual enrollment season, you can get a suitable health insurance policy for yourself and your family if you face a qualifying life event. Please, read about Special Enrollment Period plans and laws regarding health insurance in your state before you choose to buy one.