Jeffrey Wade
In the US, the Open Enrollment Period, from November 1 to January 15 each year, is when people can enroll in or make changes to their Marketplace health insurance plans. Outside of this period, changes can be made only if you qualify for a Special Enrollment Period, which is a time when you can sign up for health insurance due to a significant life event or a change in income. A qualifying life event could include losing health coverage, moving, getting married, having a baby, or a change in employment status.
| Characteristics | Values |
|---|---|
| Annual Open Season Dates | Mid-November through mid-December |
| Who Can Enroll During Open Season | Current enrollees can change their plan, new enrollees |
| Who Can Enroll Outside of Open Season | Those who have experienced a qualifying life event, such as a change in family status or employment status |
| Qualifying Life Events | Marriage, birth or adoption of a child, acquisition of a foster child, legal separation, divorce, death of a spouse or dependent, reemployment after a break in service, return to pay status after leave without pay, pay increase, restoration to a civilian position after serving in the uniformed services |
| Enrollment Types | Self Only, Self Plus One, Self and Family |
| Enrollment Changes Outside of Open Season | Enroll in the FEHB Program, change enrollment, change to Self Only, or cancel coverage |
| Enrollment Changes After Cancelling Coverage | Must wait for the next Open Enrollment Period to enroll again |
| Special Enrollment Period | A period outside of Open Enrollment when individuals can enroll in or change Marketplace plans due to a qualifying life event or income below a certain amount |
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What You'll Learn
- You can change your medical insurance outside of open season if you experience a qualifying life event
- You can change your plan if you lose health coverage
- You can cancel your coverage and wait for the next open enrollment period
- You can change your plan if your family status changes
- You can change your plan if your employment status changes
You can change your medical insurance outside of open season if you experience a qualifying life event
Typically, you can only change your medical insurance during the open enrollment period, which is a yearly period when people can enroll in a Marketplace health insurance plan. However, you can change your medical insurance outside of the open enrollment period if you experience a qualifying life event.
Qualifying life events include certain changes in your life situation that may impact your current health insurance coverage and make it necessary to enroll in a new plan. These events can include a loss of health coverage, a change in your household, or a change in residence. For example, losing your job and, consequently, your health insurance, would be considered a qualifying life event. In this case, you would qualify for a Special Enrollment Period (SEP), which is a period outside of the open enrollment period when you can enroll in or change your Marketplace plan due to a life event or based on your income.
Other examples of qualifying life events include getting married, having a baby, adopting a child, turning 26, getting divorced, or experiencing the death of a spouse. If you experience any of these life events, you may be eligible to change your health insurance plan outside of the open enrollment period. It's important to note that you may be required to provide documentation of your qualifying life event when enrolling in a new plan.
The timeframe for making changes to your health insurance after a qualifying life event is typically 60 days before or after the event. This means that if you know you will soon experience a qualifying life event, it's a good idea to contact your insurer or the Marketplace in advance to avoid a coverage gap. Additionally, if you are a new employee, you may have up to 60 days after your date of appointment to enroll in a new health insurance plan.
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You can change your plan if you lose health coverage
In the US, the yearly Open Enrollment Period, from November 1 to January 15, is when people can enroll in or change their Marketplace health insurance plan. Outside of this period, you can still change your plan if you qualify for a Special Enrollment Period. A Special Enrollment Period is a time outside the yearly Open Enrollment Period when you can sign up for health insurance due to a life event or based on your income.
You can qualify for a Special Enrollment Period if you've experienced certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount. For example, you may qualify for a Special Enrollment Period if you lose qualifying health coverage you had through a parent, spouse, or other family member. This might happen if you turn 26 and can no longer be on a parent's plan, or if a family member loses health coverage or coverage for their dependents.
You usually have 60 days from the life event to enroll in a new plan, but you should report your change as soon as possible. If you qualify for a Special Enrollment Period, you can shop for plans and enroll in one that meets your needs. It's important to have health coverage to protect yourself from unexpected medical expenses and to get regular care, including free preventive services.
In addition to losing health coverage, there are other qualifying life events that may allow you to change your plan outside of the Open Enrollment Period. These include getting divorced or legally separated, the death of a family member, or a change in your family status that results in an increase or decrease in the number of eligible family members, such as your spouse's death or your divorce.
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You can cancel your coverage and wait for the next open enrollment period
You can cancel your health insurance coverage at any time, but it is highly recommended that you do not go without health insurance. Medical care without insurance is very expensive, and health coverage helps you get regular care, including free preventive services, to keep you healthy.
If you cancel your health insurance coverage, you may have to wait for the next Open Enrollment Period to enroll in a new plan. The Open Enrollment Period typically runs from November 1 to January 15 each year. During this period, you can enroll in or change your Marketplace health insurance plan.
Outside of the Open Enrollment Period, you can only change your health insurance plan under certain circumstances. These circumstances include specific life events, such as losing your current health coverage, moving, getting married, having a baby, or adopting a child. You may also qualify for a Special Enrollment Period if your household income falls below a certain level.
If you are a federal employee, you may have additional opportunities to change your health insurance outside of the Open Enrollment Period. For example, you can change your enrollment within 60 days of experiencing a qualifying life event, such as a change in family status (e.g., divorce or the death of a spouse) or a change in employment status (e.g., returning to work after a break of more than three days).
Remember that going without health insurance, even for a short period, can be risky and costly if you unexpectedly need medical care. Carefully consider your options and try to maintain continuous health coverage to protect your health and finances.
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You can change your plan if your family status changes
In most cases, you can only change your medical insurance during the yearly Open Enrollment Period, which is from November 1 to January 15. However, certain life events, such as changes in family status, allow you to make an exception to this rule.
A family status change is a qualifying event that enables you to make changes to your benefits. This includes events such as marriage, divorce, the birth or adoption of a child, and changes in your spouse's employment. If you experience a change in family status, you are permitted to make changes to your insurance plan. For example, you may add or remove a dependent from your coverage following a marriage or divorce.
In the case of a divorce, you must remove your ex-spouse from your coverage. Your ex-spouse has the option to continue their coverage through COBRA and will receive the relevant information by mail. It is important to ensure that their address is up to date.
You may also make changes to your insurance plan if your spouse gains or loses health coverage or if their employer's coverage changes significantly during their company's Open Enrollment period. In such cases, you can submit a Family Status Change Request within 30 days of the date of the coverage change. It is important to note that you cannot make the request before the date of the change, and you will be required to submit documentation to verify any newly added dependents.
Additionally, changes in family status can impact your HSA contribution limits. When you switch from individual to family coverage, or vice versa, your contribution limits may be adjusted. It is important to be mindful of the regulations, such as the Full-Contribution Rule, which states that the annual contribution limit can increase but not decrease due to a change in status.
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You can change your plan if your employment status changes
Employees can make changes to their health insurance plan at any time during the year, but only if they have a qualified life status change that would affect their health insurance policy. A change in employment status is considered a qualifying life event, and other examples include getting married, having a baby, divorce, or a change in income. Employees must update their insurance provider about these changes, which may impact their eligibility, health insurance options, and monthly premium costs.
If you are a new employee, you may enroll in any available plan within 60 days of your date of appointment. You may also enroll or change enrollment during the Open Season, which typically runs from November 1 to January 15 each year. During this time, employees can renew their existing individual health plans or search for other coverage options. If you cancel your coverage, you might have to wait for the next Open Enrollment Period to enroll again.
Outside of the Open Enrollment Period, you can qualify for a Special Enrollment Period if you have experienced certain life events, such as losing health coverage, moving, getting married, having a baby, or adopting a child. You may also qualify if your household income is below a certain amount or if you have gained membership in a federally recognized tribe.
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Frequently asked questions
The Open Enrollment Period is from November 1 to January 15 each year.
Yes, but only if you qualify for a Special Enrollment Period.
You may qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
Medical care without insurance is very expensive, so it’s important to have protection if the unexpected happens.
FEHB stands for Federal Employees Health Benefits program.
