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
- 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.
- 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?
- 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.
- 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.
- 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
- Know your options. Review your current plan or contact your provider
to see what changes you can make due to a qualifying life event.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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
- 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.
- 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.
- 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.
- 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.
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