Obamacare Insurance: When To Switch Plans

In New York, the open enrollment period for Obamacare insurance plans is from November 16 to January 31. However, for 2024 coverage, New York State of Health has extended the enrollment period until May 31, 2024, due to the unwinding of the pandemic-era continuous coverage rule for Medicaid. After this period, a qualifying life event will be necessary to sign up for coverage. Outside of the open enrollment period, a special enrollment period allows individuals to enroll in an ACA-compliant plan if they experience a qualifying life event, such as losing health coverage, moving, getting married, having a baby, or adopting a child. It's important to note that enrollment in Medicaid, Child Health Plus, and the Essential Plan continues year-round for eligible individuals.

Special Enrollment Periods

Qualifying life events include:

• Loss of health coverage
• Moving to a new home
• Getting married
• Having a baby
• Adopting a child
• Placement of a child in foster care
• Becoming a US citizen
• Changes in income
• Gaining membership in a federally recognized tribe
• Leaving incarceration

If you qualify for a Special Enrollment Period, you will have 60 days before or after the event to enroll in a new plan. You can also change plans during a Special Enrollment Period if you qualify.

In New York, individuals and families can enroll in a private health plan outside of the Open Enrollment Period if they have experienced a Qualifying Life Event. Examples of Qualifying Life Events include:

• Loss of minimum essential coverage
• Marriage or domestic partnership
• Birth, adoption, or placement in foster care
• Becoming a citizen, national, or lawfully present individual
• Permanent move to New York, or permanent move from one county to another within New York
• Marketplace staff or contractor enrollment error
• Qualified Health Plan violated a provision of its contract
• American Indians can enroll or change plans once per month throughout the year

If you are applying for a Qualified Health Plan in New York, you must apply within 60 days of the Qualifying Life Event.

Open Enrollment

During Open Enrollment, you can renew, change, or update your insurance plan. You can make multiple health insurance plan selections during Open Enrollment, as long as you complete the final plan change by the end of the enrollment period. If you don't take any action during Open Enrollment, you may be automatically re-enrolled for the following year's coverage. However, it's important to update your expected income and household information for the new year to ensure you get the right amount of savings.

If you miss the Open Enrollment deadline, you won't be able to make a plan change for the rest of the year unless 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 certain qualifying life events, such as losing health coverage, moving, getting married, having a baby, or adopting a child.

Losing health coverage

Losing your health coverage can be a stressful and challenging experience, but there are options available to help you get the coverage you need. Here are some important things to know about losing your health coverage and how to navigate this situation:

• Special Enrollment Period: If you lose your health coverage, you may qualify for a Special Enrollment Period. This is a time outside the yearly Open Enrollment Period when you can sign up for a new health insurance plan. You generally have 60 days from the loss of your coverage to enroll in a new plan. Make sure to report your change in coverage as soon as possible and update your application.
• Marketplace Plan Options: During the Special Enrollment Period, you can enroll in a Marketplace plan through the Health Insurance Marketplace. You can create an account and preview plans and estimated prices based on your income. You may also qualify for savings on your monthly premiums or a tax credit to lower your insurance payments.
• COBRA Coverage: Another option to consider is COBRA continuation coverage. This allows you to keep your previous health plan for a limited time, usually 18 months, after losing your job. You will typically need to pay the full premium yourself, plus a small administrative fee. Contact your former employer to learn about your COBRA options.
• Medicaid and Children's Health Insurance Program (CHIP): Depending on your income and family situation, you may be eligible for free or low-cost coverage through government-sponsored programs such as Medicaid or CHIP. These programs provide coverage for low-income individuals, families, children, pregnant women, and people with certain disabilities.
• New York State of Health: If you live in New York, you can explore health insurance options through NY State of Health, the state's official health plan marketplace. They offer a range of low-cost, quality health insurance plans for individuals and families. NY State of Health also provides access to the Essential Plan, which offers premium-free coverage for those with incomes too high to qualify for Medicaid but not exceeding a certain poverty level.
• Short-Term Health Insurance: If you need temporary coverage while you transition to a new plan, you can consider short-term health insurance. These plans provide temporary coverage for consumers who find themselves without comprehensive insurance. However, be sure to review the terms and conditions carefully, as short-term plans may have limited benefits and exclusions.

Remember to act promptly when you lose your health coverage to ensure you have continuous protection. Losing health coverage can be a qualifying life event that triggers a Special Enrollment Period, allowing you to make necessary changes to your insurance plan.

Moving

If you move to a new state, you will need to start a new Marketplace application and enroll in a new plan in your new state. You cannot keep your old plan. It is important to report your move as soon as possible to avoid a break in coverage and to avoid paying for coverage that doesn't apply in your new state.

If you move within the same state, you will need to update your application to report your change of address. Your coverage options and savings may change based on your new address.

If you work for a large employer with business locations across the country, your coverage may remain unchanged. However, if you buy your health insurance on the individual market, you will have to purchase a new plan.

To apply for a new plan, you will need to log in to your Marketplace account and select the year and your new state. If your new state runs its own Marketplace, you will need to use its website to apply. You can then compare plans and prices and pick a new plan.

Getting married

The Special Enrollment Period typically lasts for 60 days following your wedding. It is important to report your change in status as soon as possible, and you should have all the necessary paperwork ready to update your application. If you miss the chance to enrol during this period, you will likely have to wait until the next Open Enrollment Period to make changes to your insurance.

There are several benefits to putting your spouse on your health insurance plan. Firstly, it can help you save money, especially if you get insurance through your employer. Even if you get insurance on the marketplace, you could still save a significant amount. Additionally, having your spouse on your policy reduces the amount of paperwork and makes it easier to keep track of your coverage and benefits.

However, there are also some potential drawbacks to consider. There could be a spouse surcharge charged by your employer, making it more expensive to include them on your plan. Furthermore, if you lose your job, both you and your spouse could suddenly lose health insurance coverage. Lastly, it might make it more challenging to switch insurance plans in the future, as you will now need to find a policy for two people instead of one.

It is essential to carefully consider your options and understand the implications of mixing health insurance and marriage. You should also be aware that, in some cases, a family health insurance plan offered by your employer may be more expensive than a similar plan chosen through a private, state, or federal marketplace.

Frequently asked questions