When Can You Change Health Insurance Plans?

If you’ve ever faced an outrageous bill or were even somewhat unsatisfied with your health insurance, you may have asked, “Can I switch my health insurance at any time?” 

Knowing the answer to this question can make all the difference in receiving the care you need by ensuring that you have the right healthcare coverage.

Keep reading to discover the key moments throughout your life when you are able to make a change in your insurance plan, including the yearly open enrollment period, several qualifying life events, and the specific rules for employer-sponsored insurance, Medicaid, and Medicare. 

We’ll also explore how you can find affordable health coverage by comparing various health plans based on a variety of factors, such as your zip code, monthly premium budget, and overall benefits. 

Knowing when you can change your health insurance is important for many reasons. Whether it’s to avoid a coverage gap or to save money by switching to a plan with lower premiums, knowing the answer can spell the difference between being covered in an emergency or not. 

Annual Open Enrollment Period

The annual open enrollment period is a designated time of year when individuals and families can make changes to their current health insurance coverage for the year. 

The enrollment period typically occurs during the fall and lasts for about six weeks. The timeframe between when it opens and closes provides an opportunity to review and compare different health plans. 

During this time, individuals and families can enroll in a new plan, make changes to their existing plan, or cancel their health insurance coverage altogether. 

These six weeks during the fall are important because it’s often the only time people can make changes to their health insurance coverage unless they have a qualifying life event. We’ll get more into those next.

It’s important to remember that, unless you experience a qualifying event, missing this enrollment period can result in you being locked into your current health plan for the upcoming year. 

That’s why it’s of utmost importance that you pay attention to the annual open enrollment period dates each year and take advantage of this opportunity. 

Helpful Tips

1. Start early. Always review your health insurance options as soon as possible. Start early and allow yourself plenty of time to research the different plans, coverage, and costs. 
2. Assess your health needs. Use this time to think about your current and future healthcare needs. Will you need any upcoming medical procedures or prescription medicine, or do you want to add any dependents for the next year? 
3. Review your current plan details. Go beyond the monthly premium. Always look at how much your plan’s deductibles, out-of-pocket maximums, and co-payments amount to. Knowing this can help you select the most cost-effective plan. 
4. Double-check your network. If you have a doctor you love, make sure they’re included in the provider network for any of the plans that you’re considering. 
5. Compare the marketplace plans with your employers. If your employer offers health insurance and contributes to the cost, consider choosing a plan that’ll maximize your employer’s contributions. 

Qualifying Life Events

The only real way to change your health insurance plan outside of the annual open enrollment period is through qualifying life events. These are specific changes in your life, such as:

• Losing coverage due to job loss
• Marriage or divorce
• Birth or adoption
• Change in residence
• Death of spouse or dependent

As you can see, qualifying life events are events that significantly change a person’s life in a way that may affect their health coverage needs. This policy was designed to ensure that individuals and families have access to health coverage when they need it, despite experiencing a significant life change. 

Helpful Tips

1. Know your options. Review your current plan or contact your provider to see what changes you can make due to a qualifying life event. 
2. Act quickly. In most cases, health insurance plans provide a limited window in which you can make changes. Be sure you act quickly so that you have continuous coverage and avoid any gaps. 
3. Get your documents ready. Some providers may require documentation of the event before allowing any changes to your coverage. Get all the documents you need ready to send to avoid any delays. 
4. Review your options. If you have options, take the time to review them and compare the costs, benefits, and networks of each plan to ensure you get the one that best meets your needs. 

Employer-Sponsored Health Insurance

Employer-sponsored plans are a common way for many individuals and families to obtain their health insurance. With this type of plan, employers will typically pay a portion of the premium cost. 

Most employers will also have an annual open enrollment period where employees can make changes to their health insurance coverage. This is typically during the same time as the annual open enrollment period during the fall. 

However, you will also be allowed to make changes to your plan if you experience a qualifying life event or if there’s a special enrollment period due to the employer changing health insurance. 

In most cases, missing the annual open enrollment period means you’ll be locked into the current plan for the rest of the upcoming year. 

Helpful Tips

1. Understand your employer-sponsored plan. Before making any changes to your plan, be sure to have a solid understanding of what it entails. Review the documents and get a general understanding of the coverage levels and financials. 
2. Research your options. If you’re considering changing your plan, be sure to review all the other plans your employer currently offers and research individual health plans to determine if there’s one that better meets your needs. 
3. Prepare any questions. Prepare a list of questions to ask your employer. Be sure to ask about the enrollment periods, how to make changes to your coverage, and if you can change to other plan options. It pays to be open and honest about your needs and concerns and why you’re considering a change. 
4. Follow up. Be sure to follow up to ensure that any changes are implemented correctly. Review the new plan documents to ensure that the coverage and benefits are what you agreed upon and that they meet your needs. 

Medicaid and Medicare

Medicare and Medicaid are both government-sponsored health insurance programs that provide coverage for a substantial number of Americans. Coverage for these programs always starts on the first of the month, and if you qualify for Premium-free Part A, coverage will start the month you turn 65. 

There’s also the general enrollment period which allows individuals to sign up between January 1 and March 31 each year. In this case, coverage starts the month after signing up, and individuals may incur a monthly late enrollment penalty if they don’t qualify for a special enrollment period. 

Helpful Tips

1. Understand the eligibility requirements. Before making any changes to your Medicaid or Medicare coverage, it’s important to understand each program’s eligibility requirements. Review the asset and income requirements and ensure that you meet the program’s qualifications. 
2. Review your current coverage before making any changes. Review your current health plan coverage and identify any gaps or areas where you may require additional coverage. 
3. Seek assistance. Oftentimes, the process of changing Medicaid and Medicare coverage can be complex. Don’t hesitate to seek out assistance from a licensed health insurance agent or a Medicaid and Medicare representative. 
4. Prepare the necessary documentation. Like with any changes to health insurance plans, you may need to provide documentation to support your eligibility. Be sure to gather all the necessary documents to ensure a smooth transition. 

Find Affordable Healthcare through an Independent Broker 

Understanding when you can change your health insurance plan is critical in ensuring that you have the best coverage to meet your healthcare needs. 

From the annual open enrollment period to qualifying life events, there are multiple opportunities for you to reevaluate and adjust your health insurance. As you navigate the complex waters of the health insurance world, consider exploring our affordable health plans 

We offer a wide range of services that aim to make health coverage more accessible and affordable to individuals and businesses. 

Contact Doug Myrick or visit our website to learn more today. 

 

What Happens if You Don’t Enroll in Medicare on Time?

You already know that you become eligible for Medicare at age 65. But what if you don’t enroll? In some cases, you could face a penalty when you do enroll later (in the form of higher premiums). But there are exceptions to this rule.

If you or your spouse are still working when you reach age 65, and you’re covered by an employer’s group healthcare plan, you might be eligible to delay your enrollment in Medicare. If the employer has more than 20 employees, you can stick with their group plan without facing a penalty from Medicare later.  However, you should note that Medicare does not consider COBRA creditable coverage.  If you are over 65 and losing employer group coverage, you must enroll into Medicare withing 60 days of losing coverage.

At some point, you will either retire or otherwise separate from that employer. You will then have eight months to enroll in Medicare. However, if you miss that enrollment deadline, you will face the penalty for late enrollment.

If you’re not covered by an applicable employer’s group benefits plan, then you’re required to enroll in Medicare when you turn 65. The enrollment window begins three months before your birthday month, extends throughout that month, and then for three months afterward.

Those who neglect to enroll promptly will face a ten percent penalty for each year that they delayed enrollment. These penalties are added to the Part B premium.

If you fear that you won’t be able to afford your Medicare premiums, you can apply for the Medicare Savings Program, which will cover the premiums if you qualify. Those who qualify will also become eligible for the Extra Help program, which helps with the cost of a Part D (prescription) plan.

Remember that we’re here to help as you make decisions about your Medicare plan. Assistance is always free, so give us a call to speak with a licensed agent if you have any questions about your Medicare enrollment or the different plans available to you.

- Myrick