What is a Qualifying Event?
The Affordable Care Act established an open enrollment period each year during which consumers can enrollment in a new health insurance plan or change plans. When open enrollment ends in February it is no longer possible to purchase health insurance coverage until November. The majority of Affordable Care Act-compliant health insurance plans are not available outside of the open enrollment period.
UNLESS you have a qualifying event that activates a special open enrollment period – usually a 60 day window – during which to enroll in a new plan or switch to a different plan.
Here are some of the events that could trigger a special open enrollment period.
- Involuntary loss of other coverage. This does not include those who cancel their plan or lose it for failing to pay the premiums.
- Becoming a dependent, or gaining a dependent through a birth, adoption or placement in foster care.
- Becoming a U.S. citizen
- A permanent move to a new state, because each state has its own health plans. Even a move within a state can be a qualifying event if you move to a part of the state that has plans that were not available in your previous area.
- A error or problem with enrollment.
- Employer-sponsored coverage reduction in benefits so that it no longer provides minimum value, or it becomes unaffordable.
There are some groups for whom enrollment is open year round. American Indians don’t need a qualifying event to enroll, and Medicaid enrollment is open year-round.
Comparing and selecting a health insurance plan and enrolling at the right time can be confusing and time consuming. Your Insurance Gal is here to make the process easier to understand and to get through. Go to health insurance Vancouver WA to learn more about our services.