Life-Changing Events: Aetna Insurance Eligibility And You

Life-changing events can impact your health insurance plan, and you may be able to change your coverage outside of the usual enrollment period. Aetna offers the opportunity to change your plan if you have experienced a qualifying life event, such as job loss, marriage, or having a new child. Other qualifying events include moving, aging out of your parents' plan, or losing your previous health coverage. It's important to note that each plan has its own guidelines, so it's recommended to act quickly and reach out to your plan administrator to understand your options and make informed decisions.

Marriage or a new child

If you experience a qualifying life event, you typically have 30 to 60 days during the special enrollment period to choose a new plan or add a dependent. However, each plan has its own guidelines on how to handle changes, so be sure to check the rules of your plan and reach out to your plan administrator to find out your options.

In addition to marriage and new children, other common qualifying life events include aging out of your parents' plan when you turn 26, losing your job, and losing a spouse.

Loss of previous coverage

Losing your previous coverage is a qualifying life event that allows you to change your health insurance plan outside the usual enrollment period. This typically happens when you lose your job or change jobs, which means giving up the health plan you had through your employer.

If you lose your health coverage, you may be able to switch to a new plan. You usually have 30 to 60 days during the special enrollment period after the life event to choose a new plan or add a dependent. You can also join a government program such as Medicaid or stay on your parent's health plan until you turn 26.

It's important to note that you may need to submit documents confirming your life event when applying for a Special Enrollment Period. Additionally, if you choose to drop your coverage as a dependent, you must also have a decrease in household income or a change in your previous coverage that makes you eligible for savings on a Marketplace plan.

Losing previous coverage is a significant life change, and understanding your options can help you make informed decisions about your health coverage. You can contact your plan administrator or Aetna Member Services for more information on how to handle changes and explore your options.

Moving

Aetna members can reach out to their plan administrator to find out their options. During a major life change, your health care plan shouldn’t be a concern. You typically have 30 to 60 days during the special enrolment period after the life event to choose a new plan or add a dependent.

If you are unsure whether your move qualifies as a life-changing event, you can visit Healthcare.gov or check with your current benefits administrator for more information. It is important to act quickly, as you usually have a limited time to make changes to your plan after a qualifying life event.

Other qualifying life events that may allow you to change your coverage include:

• Marriage or domestic partnership
• Divorce or separation
• Birth or adoption of a child
• Loss of previous coverage
• Job loss

Natural disasters

Property Damage and Displacement: Natural disasters such as hurricanes, tornadoes, earthquakes, wildfires, and floods can cause extensive damage to homes and property. This damage may render a home uninhabitable, leading to temporary or permanent displacement of the residents. Insurance companies typically recognize the need for immediate housing solutions and financial assistance in such cases.

Financial Hardship: The financial implications of a natural disaster can be significant. Repairing or rebuilding a home, replacing personal belongings, and addressing medical expenses related to injuries sustained during the event can place a tremendous burden on individuals and families. Insurance providers often consider the financial hardship resulting from a natural disaster as a qualifying factor for a life-changing event.

Emotional and Psychological Impact: Experiencing a natural disaster can have profound emotional and psychological effects on individuals. The trauma of losing one's home, the stress of relocation, and the fear for one's safety can lead to mental health issues such as anxiety, depression, and post-traumatic stress disorder. Insurance companies may take into account the potential for long-term emotional and psychological consequences when determining whether a natural disaster qualifies as a life-changing event.

Community Disruption: Natural disasters often affect entire communities, disrupting essential services, infrastructure, and social networks. Schools may be closed, businesses may be destroyed, and transportation systems may be damaged. The recovery process for a community can be lengthy and challenging. Insurance companies may recognize the broader impact of a natural disaster on the community when assessing life-changing event qualifications.

When a natural disaster occurs, it is important for individuals to contact their insurance providers as soon as possible to understand their coverage options and receive guidance on the next steps. Insurance companies may offer special provisions or assistance programs specifically designed to help individuals and families recover from these types of catastrophic events.

Job loss

Losing your job is a qualifying life event for Aetna, meaning that you can change your health insurance plan outside of the usual enrollment period. This is true whether you lose your job or change jobs, as you will likely lose the health plan you had through work.

If you are under the age of 26, you can be added to your parents' health insurance plan. If you are over the age of 26, you can join a spouse's or partner's plan or buy individual coverage. You can also join a government program such as Medicaid. If you are over 65, you can opt for Medicare.

If you were already on an employer-sponsored medical, dental, or vision plan, you can continue to use this insurance after a job loss with COBRA (the Consolidated Omnibus Budget Reconciliation Act). Your company must have 20 or more employees, and you will usually have 60 days after losing your coverage to join. You can also use a health savings account (HSA), health reimbursement arrangement (HRA), or individual retirement account (IRA) to pay your premiums. However, COBRA can be expensive, and there is no COBRA coverage offered if your employer has gone out of business.

Short-term health plans can work as a quick and cheap fix for 1 to 12 months, but they do not meet the required benefits of the Affordable Care Act. For example, they do not have to cover pre-existing conditions, prescription drugs, or mental health services.

You can also visit the Health Insurance Marketplace at HealthCare.gov to shop for ACA individual and family plans. Most people who don't qualify for Medicaid can join at the marketplace, and many people pay little or no monthly premiums. You can join within 60 days of losing your coverage or during the next open enrollment period from November 1 to January 15.

Frequently asked questions